Vocal cords paresis: causes, symptoms and methods of treatment

At present, the larynx is one of the most complex organs of man. Even in ancient times, they began to study its structure and are still doing it. There are a lot of varieties of lesions of the larynx, but one of the most interesting is the paresis of the vocal cords. It manifests itself in the form of a decrease in the motor functions of the muscles of this organ, as a result of which there is a violation of breathing and voice formation. At the moment, this disease is the third part of all chronic diseases of the larynx. It is quite dangerous, and effective treatment depends on the accuracy of the causes.

How is the development of the disease?

The anatomy of the larynx involves the presence of vocal cords that are parallel to each other. Between them is a voice gap. With the expiration of air through this hole, vibration, vibration of ligaments and a voice is created. Thus, the mechanism of the larynx works, performing the function of phonation.

The muscles of this organ respond to impulses that flow along small branches from the central nervous system. If any damage or pathology occurs, a disruption of the relationship between the brain, the nervous system and the muscular apparatus occurs. As a result of this development of events, there is a paresis of the vocal cords and, accordingly, the larynx.

Typology of the disease

This ailment is divided into three types: myopathic (associated with the muscular apparatus), neuropathic (due to disorders of the laryngeal nerve) and functional (problems with the balance of excitation and inhibition in the cerebral cortex).

The defeat of the vocal apparatus may be unilateral or bilateral. In addition, pathology is congenital and acquired. The first is characterized by the development of the most severe form - paralysis of the larynx. Those who suffer from this disease can not move the muscles of the organ.

Myopathic appearance

Let's consider each of the types of voice vocal cords in detail. Myopathic form of the disease is formed as a result of inflammatory changes in the larynx due to the increase in the number of microorganisms. Infectious viruses are similar.

This type of disease also occurs when dust and dirty substances enter the throat. Cold air and excessive stress can become factors of paresis of the right vocal cords or the left one. Sometimes there is a bilateral nature of the disease. Symptoms can be distinguished here:

• hoarse voice;
• Changing the timbre;
• It is impossible to reproduce high sounds;
• Intermittent speech;
• The opportunity to speak only in a whisper.

Neuropathic appearance

This type of paresis of the vocal cords and larynx is the most common. It, in turn, is divided into two subspecies: peripheral and central. The first is characterized by damage or lesion of the laryngeal nerve. And the second is formed as a result of a trauma of a trunk and a cortex of a brain.

If one-sided pathology develops, then breathing and the voice-forming function work in the norm, a bit later there is hoarseness of the voice. Restoration of the laryngeal nerve takes several months. However, if the patient is a singer, then he will have to be upset, the vocal abilities will never be the same. Two-sided pathology is characterized by a very severe condition, which can lead to suffocation.

Symptoms:

• Noisy breathing;
• To facilitate the process, the patient in the sitting position rests against something with his hands;
• The skin becomes blue.

Functional view

The peculiarity of this type of laryngeal paresis is that it manifests itself only against the background of instability of the nervous system. The main sign of the functional form of the ailment is a whisper, passing into aphonia. If the patient is passionate about something, he may not even notice that the voice is lost, it appears.

Usually paresis is formed as a result of the appearance of laryngitis or another disease. Imaginary patients, who are now quite a lot, talk in whispers until they cure the underlying disease. They often tell the doctors that they are being treated incorrectly. Typically, these patients have the following symptoms:

• a sore throat;
• Titillation and perspiration;
• Dizziness and pain in the head;
• insomnia.

Treatment of the functional type of the laryngeal paresis takes quite a long time. It is recommended to connect a psychotherapist or psychoanalyst. Sometimes patients complain that the voice is gone (the throat does not hurt, there is no temperature). This may be due to a more serious stage of the disease.

Causes of the disease

This disease is caused by a huge number of reasons. Paresis occurs as a result of unsuccessful surgery on the thyroid gland and not only. About 6% of cases end with paresis of the vocal cords. Also, various injuries and damage to nerve structures, bruises at home and at work, etc., can cause the appearance of an ailment.

The main causes of paresis of the vocal cords are:

• The appearance of metastases, tumors of the neck, chest, larynx and trachea;
• An increase in the thyroid gland, occurring against a background of other diseases;
• Benign tumors in the larynx;
• Hematomas after injury;
• Stroke, congenital heart disease;
• Neuritis, which occurs against the background of infectious viral diseases.

The voice device is subjected to serious stress in people who are professionally vocals. They often develop a larynx paresis. Sometimes this ailment appears as a result of stress and mental illness.

Symptoms of the paresis of the vocal cords

The clinical picture of the disease will depend on the degree of damage to the larynx and vocal cords, as well as the prescription for the development of the disease. The most vivid signs are manifested in unilateral paresis with abnormalities in the functioning of the vocal cords:

• Hoarseness of voice;
• fast fatiguability;
• The voice was gone (the throat does not hurt, there is no temperature);
• dyspnea;
• Pain in the pharynx;
• Problems with the mobility of the language;
• There is a foreign body in the throat, a sensation of a coma;
• Coughing or strong attack of cough;
• Insomnia, headache.

There are cases when paresis does not show itself externally. With this development of events, the ailment can only be detected by a doctor with a thorough examination. As for bilateral lesions of the larynx, they are characterized by aphonia and respiratory insufficiency. Sometimes a barking cough is observed in the paresis of the vocal cords. In rare cases, the disease develops so quickly that in a few hours an emergency medical intervention is required.

Diagnostics

When the first signs of paresis appear, you should immediately contact the otolaryngologist. Before the doctor there is a main task - to correctly determine the cause of the disease. To do this, it is necessary to undergo several examinations, as well as get advice from other specialists, for example, a neurologist, an endocrinologist, a surgeon, a psychiatrist, etc. Particular care must be taken to examine the history of the patient's illnesses and find out the presence of surgical interventions.

To make the correct diagnosis use:

• Laryngoscopy or microlaringoscopy;
• Tomography of the larynx, brain, thorax;
• Electromyography;
• Stroboscopy and phonography;
• Ultrasound examination of the heart and thyroid;
• General and biochemical blood analysis.

If organic changes were not detected, then often the diagnosis is "functional larynx paresis".

Methods of treatment

In fact, paresis of the vocal cords is subject only to complex treatment. The peculiarity of therapy is that before the appointment of a recovery course it is necessary to identify the cause of the disease. For full-fledged treatment, hospitalization is recommended. Treatment of the paresis of the vocal cords in the hospital is carried out with the help of the following options:

• Antihistamines, decongestants;
• Antibiotics, antiviral agents, vitamins;
• Psychotropic drugs, nootropics;
• Hormonal drugs, electrophoresis;
• Acupuncture, electrostimulation of nerves, massage.

Very often, in the treatment of paresis, surgical intervention is necessary. It is used in the presence of tumors, scarring or uselessness of drug therapy. There are several methods of such treatment, the most common of them is the surgery of the organs, in which the cause of the disease lies, and the placement of implants.

Surgical intervention is quite effective, but depends on the individual characteristics of the body and the duration of the disease. After the operation, the paresis of the vocal cords recedes, and the doctor recommends that the patient engage in respiratory gymnastics. On average, rehabilitation lasts about 3-4 months. During this time, it is forbidden to give heavy loads to the larynx, since relapse is possible.

Gymnastics during rehabilitation

As already noted, the doctor almost always recommends after the operation to train the respiratory process and use the phonopedia. These methods are good at all stages of treatment. Gymnastics is aimed at increasing the motor activity of ligaments and muscles. Quite effective are the following exercises:

• Blowing / drawing in slowly;
• Use of a harmonica;
• Inflating the cheeks and blowing through the slit.

During these exercises it will be useful to train the neck. Exercises on the voice are recommended to be controlled by the phoniatrician. The patient must correct the pronunciation of each sound, syllable and words.

Prophylaxis and prognosis

Why engage in the treatment of the disease, if you can not prevent it. The question of preventing paresis of vocal cords is especially acute. In order to avoid the appearance of an illness with the maximum probability, you should do the following:

• Correctly treat infectious and viral pathologies;
• Not to tolerate intoxication;
• Do not overload the vocal cords;
• Do not overcool;
• To monitor the normalization of the thyroid gland and other internal organs.

The prognosis strongly depends on the causes of the disease and the methods of treatment. If all the problems have been completely prevented, then with the correct course of rehabilitation, the respiratory and septic functions of the larynx are restored. If the patient has a functional paresis, he can recover on his own. Of course, with the correct distribution of the load on the larynx. With the development of the disease for a long time there is muscle atrophy and complete loss of voice. In the most severe situations paralysis of the larynx is manifested, which can bring huge harm to health.