Paraplegia approach

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https://www.michaelpitmanmd.com/ • Vocal Fold Paralysis • Normally the vocal folds are able to open and close symmetrically. Unilateral vocal fold paralysis is immobility of one vocal fold because of nerve dysfunction in the recurrent laryngeal nerve—the main nerve that accounts for most of the movement of each vocal fold. A vocal fold may also be immobile due to a mechanical dysfunction of the joint secondary to trauma or disease. (For information on bilateral vocal fold paralysis, click here.) ((LINKS TO PAGE B3)). • • Damage to the recurrent laryngeal nerve can be caused by various diseases, certain surgeries, and probably viral infections. Such diseases include thyroid cancer, metastatic cancer, sarcoidosis, stroke, and various neurologic diseases, such as Charcot-Marie-Tooth, Shy-Drager, and Multisystem atrophy. Surgeries that can result in vocal ford paralysis include thyriodectomy, thymectomy, carotid endarterectomy, lung operations, heart operations, anterior cervical discectomy, mediastinoscopy/mediastinal lymph node biopsy, closure of patent ductus arteriosus, and brain surgery. Vocal fold immobility from mechanical dysfunction may be due to scar tissue after prolonged intubation, dislocation of the joint, or from diseases such as arthritis that cause the joints to be stiff. • • The most noticeable symptom is the dramatic voice change: the voice becomes hoarse, breathy, and weak, and speaking at loud volume or over background noise becomes very challenging. People may also find that they occasionally cough or choke when swallowing, particularly when swallowing liquids. • • Diagnosing the paralysis is straightforward and is based on a patient’s history as well as a visual examination of the throat using a miniature camera. To find the cause of the paralysis, physicians may also perform a cat scan of the neck and chest or an electromyogram (EMG) test. • • Treatment Prognosis: Individualized for every patient, treatment depends upon the cause and duration of the paralysis, and the extent of the disability. Some cases of vocal fold paralysis resolve on their own, although it may take weeks to months, and if the symptoms are too bad, vocal therapy can also work. A temporary injection laryngoplasty to push the immobile vocal fold to the midline will help restore a strong voice while awaiting nerve reinnervation. The injection itself may also help encourage reinnervation. If the immobility is permanent, it is almost always possible to achieve a normal or near normal voice with various types of surgery and possibly voice therapy. Find out more about the various treatments for vocal fold paralysis. The prognosis for vocal fold paralysis is excellent, and our treatment options at the Voice and Swallowing Institute have excellent outcomes. • WEBSITE • https://www.michaelpitmanmd.com/ • http://entcolumbia.org/our-services/v... • SOCIAL • FACEBOOK: / michaelpitmanmd • INSTAGRAM: / michaelpitmanmd

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