Vocal Fold Paresis/ Paralysis
Vocal fold paresis (weakness) or paralysis (complete absence of movement) may result from a viral infection, cerebral vascular accident (stroke), trauma to the head, recurrent laryngeal nerve damage following surgery to the head, neck, or chest region, or may be ideopathic (cause unknown). A tumor may also cause immobility of the vocal fold(s). Vocal characteristics consistent with vocal fold paresis/ paralysis include breathiness, hoarseness, diplophonia (audible perception of two distinct pitches), decreased pitch range, and an inability to increase loudness.
Treatment
Treatment will vary depending on the cause of the paresis/ paralysis, but voice therapy and surgery are two common treatment options. Prior to any surgical recommendations, many physicians may request a procedure called a laryngeal electromyography to assess the nerve activity and recovery potential of the larynx.
Spasmodic Dysphonia
Spasmodic dysphonia refers to group of disorders characterized by involuntary spasms of the vocal folds. The two most recognized forms are described as either adductor spasmodic dysphonia (increased closing of the vocal folds) or abductor spasmodic dysphonia (increased opening of the vocal folds). The exact cause of spasmodic dysphonia is unknown, but it is thought to have a neurological origin. Other neurological symptoms will somtimes be present, including tremor, facial ticks/ jerks, or other uncontrollable movements. Vocal characteristics include a strained/ strangled voice, or in the case of adductor spasmodic dysphonia, a breathy voice, often with pitch breaks. Symptoms often disappear in whispered or sung speech.
Treatment
Spasmodic dysphonia has been known to be resistant to treatment. A popular treatment in the case of adductor spasmodic dysphonia are Botox injections. Botox, or botulinum toxin, is injected into certain laryngeal muscles to relax the muscles and decrease spasms. Voice therapy will not “cure” spasmodic dysphonia but is often recommended to educate the patient and to instruct the patient in compensatory strategies.
ENT London is one of UK’s leading Nose Surgeon London clinics, and can be contacted on 0207 580 6970.