vocal cord paralysis


Summary: Congenital or acquired paralysis of one or both VOCAL CORDS. This condition is caused by defects in the CENTRAL NERVOUS SYSTEM, the VAGUS NERVE and branches of LARYNGEAL NERVES. Common symptoms are VOICE DISORDERS including HOARSENESS or APHONIA.

Top Publications

  1. Chen H, Jen Y, Wang C, Lee J, Lin Y. Etiology of vocal cord paralysis. ORL J Otorhinolaryngol Relat Spec. 2007;69:167-71 pubmed
    b>Vocal cord paralysis (VCP) is a sign of a certain underlying disease, a diagnosis which can be attributed to various causes. This study intends to analyze the contemporary etiology of VCP in a tertiary medical center...
  2. Chen D, Chen S, Wang W, Zhang C, Zheng H. Spontaneous regeneration of recurrent laryngeal nerve following long-term vocal fold paralysis in humans: histologic evidence. Laryngoscope. 2011;121:1035-9 pubmed publisher
  3. Reiter R, Rudolf R, Brosch S, Sibylle B. Laryngoplasty with hyaluronic acid in patients with unilateral vocal fold paralysis. J Voice. 2012;26:785-91 pubmed publisher
    ..Analysis of the optimal glottic width, effectiveness (long-term voice improvement as a consequence of longevity of Restylane), and safety of this new method was made...
  4. Graboyes E, Bradley J, Meyers B, Nussenbaum B. Efficacy and safety of acute injection laryngoplasty for vocal cord paralysis following thoracic surgery. Laryngoscope. 2011;121:2406-10 pubmed publisher
    ..laryngoplasty using a temporary injectable agent in the acute setting for patients with unilateral vocal cord paralysis following thoracic surgical procedures. Retrospective consecutive case series in an academic institution...
  5. Song S, Jun B, Cho K, Lee S, Kim Y, Park S. CT evaluation of vocal cord paralysis due to thoracic diseases: a 10-year retrospective study. Yonsei Med J. 2011;52:831-7 pubmed publisher
    To discuss computed tomography (CT) evaluation of the etiology of vocal cord paralysis (VCP) due to thoracic diseases.
  6. Wang W, Chen D, Chen S, Li D, Li M, Xia S, et al. Laryngeal reinnervation using ansa cervicalis for thyroid surgery-related unilateral vocal fold paralysis: a long-term outcome analysis of 237 cases. PLoS ONE. 2011;6:e19128 pubmed publisher
    ..To evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery...
  7. Song P, Sung C, Franco R. Voice outcomes after endoscopic injection laryngoplasty with hyaluronic acid stabilized gel. Laryngoscope. 2010;120 Suppl 4:S199 pubmed publisher
    ..Further studies are required to quantify the benefits and to compare the effects with other injectable materials. ..
  8. Arviso L, Johns M, Mathison C, Klein A. Long-term outcomes of injection laryngoplasty in patients with potentially recoverable vocal fold paralysis. Laryngoscope. 2010;120:2237-40 pubmed publisher
    ..The majority of subjects with potentially recoverable UVFP recover vocal fold motion and/or adequate voice after IL without permanent intervention. ..
  9. Duclos A, Peix J, Colin C, Kraimps J, Menegaux F, Pattou F, et al. Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study. BMJ. 2012;344:d8041 pubmed publisher
    ..Optimum individual performance in thyroid surgery cannot be passively achieved or maintained by accumulating experience. Factors contributing to poor performance in very experienced surgeons should be explored further. ..

More Information


  1. Marina M, Marie J, Birchall M. Laryngeal reinnervation for bilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg. 2011;19:434-8 pubmed publisher
    ..On the other hand, the procedure is not simple. This review explores the recent literature on surgical technique and factors that may contribute to the success...
  2. Paniello R, Edgar J, Kallogjeri D, Piccirillo J. Medialization versus reinnervation for unilateral vocal fold paralysis: a multicenter randomized clinical trial. Laryngoscope. 2011;121:2172-9 pubmed publisher
    ..ML and LR are both effective surgical options for patients with UVFP. Laryngeal reinnervation should be considered in younger patients, whereas medialization laryngoplasty should be favored in older patients. ..
  3. Duclos A, Lifante J, Ducarroz S, Soardo P, Colin C, Peix J. Influence of intraoperative neuromonitoring on surgeons' technique during thyroidectomy. World J Surg. 2011;35:773-8 pubmed publisher
    ..Such an effect on learning must be considered when assessing the impact of using IONM on patient safety. ..
  4. Ng S, Yuen H, van Hasselt C, Ahuja A. Combined ultrasound/endoscopy-assisted vocal fold injection for unilateral vocal cord paralysis: a case series. Eur Radiol. 2012;22:1110-3 pubmed publisher
    Transcutaneous vocal cord injection is a popular treatment choice for patients suffering from unilateral vocal cord paralysis. Transcutaneous transcartilaginous (through the thyroid cartilage) approach abolishes any anatomical constraint ..
  5. Lo C, Kwok K, Yuen P. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Arch Surg. 2000;135:204-7 pubmed
    ..b>Vocal cord paralysis after thyroidectomy...
  6. Dionigi G, Bacuzzi A, Bertocchi V, Carrafiello G, Boni L, Rovera F, et al. Safe incorporation of new technologies in thyroid surgery. Expert Rev Med Devices. 2008;5:747-58 pubmed publisher
    ..Searches were last updated in April 2008. ..
  7. Erbil Y, Barbaros U, Issever H, Borucu I, Salmaslioglu A, Mete O, et al. Predictive factors for recurrent laryngeal nerve palsy and hypoparathyroidism after thyroid surgery. Clin Otolaryngol. 2007;32:32-7 pubmed
    ..Extentended thyroidectomy and repeat surgery had a significant effect on the incidence of recurrent laryngeal nerve palsy and postoperative hyperparathyroidism respectively following thyroid surgery. ..
  8. Rosenthal L, Benninger M, Deeb R. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope. 2007;117:1864-70 pubmed
    ..The medical records of all patients assigned a primary or additional diagnostic code for vocal cord paralysis were obtained from the electronic database...
  9. Zealear D, Swelstad M, Sant Anna G, Bannister R, Billante C, Rodriguez R, et al. Determination of the optimal conditions for laryngeal pacing with the Itrel II implantable stimulator. Otolaryngol Head Neck Surg. 2001;125:183-92 pubmed
    ..To determine the optimal stimulus paradigm, electrode orientation, and configuration of an implantable stimulator used to reanimate the posterior-cricoarytenoid (PCA) muscle in case of bilateral vocal fold paralysis (BVFP)...
  10. Hertegard S, Hallén L, Laurent C, Lindström E, Olofsson K, Testad P, et al. Cross-linked hyaluronan used as augmentation substance for treatment of glottal insufficiency: safety aspects and vocal fold function. Laryngoscope. 2002;112:2211-9 pubmed
    ..However, the patients treated with hylan B gel showed better vocal fold status and longer maximum phonation time at 12 months after treatment as compared with patients treated with collagen. ..
  11. Merati A, Shemirani N, Smith T, Toohill R. Changing trends in the nature of vocal fold motion impairment. Am J Otolaryngol. 2006;27:106-8 pubmed
    ..Anterior cervical spine surgery surpassed thyroidectomy and all other procedures as the most common cause of iatrogenic VFMI in this contemporary study. ..
  12. Azadarmaki R, Mirza N, Soliman A. Unilateral true vocal fold synkinesis presenting with airway obstruction. Ann Otol Rhinol Laryngol. 2009;118:587-91 pubmed
    ..We present a case series of 10 patients with unilateral true vocal fold paralysis who presented with airway obstruction...
  13. Chou F, Su C, Jeng S, Hsu K, Lu K. Neurorrhaphy of the recurrent laryngeal nerve. J Am Coll Surg. 2003;197:52-7 pubmed
    ..Neurorrhaphy of the recurrent laryngeal nerve is a simple and effective procedure to improve voice quality, aspiration, GRBAS scales, glottal gap, and maximum phonation time by preventing atrophy of the vocal cord. ..
  14. Fang T, Li H, Gliklich R, Chen Y, Wang P, Chuang H. Outcomes of fat injection laryngoplasty in unilateral vocal cord paralysis. Arch Otolaryngol Head Neck Surg. 2010;136:457-62 pubmed publisher
    To analyze outcomes following fat injection laryngoplasty in patients with unilateral vocal cord paralysis. Longitudinal outcomes evaluation study. Tertiary referral voice center...
  15. Sulica L. The natural history of idiopathic unilateral vocal fold paralysis: evidence and problems. Laryngoscope. 2008;118:1303-7 pubmed publisher
    ..All of these factors should be addressed in future prospective studies to shed further light on the natural history of vocal fold paralysis. ..
  16. Lichtenberger G. Prevention and management of bilateral vocal cord paralysis by and after thyroid surgery. Otolaryngol Pol. 2004;58:165-71 pubmed
    ..The vast majority of the cases referred to the department suffering from bilateral vocal cord paralysis were the consequences of thyroid surgery and its complications...
  17. Tokashiki R, Hiramatu H, Tsukahara K, Kanebayashi H, Nakamura K, Motohashi R, et al. A new procedure of arytenoid adduction combined with type I thyroplasty under general anesthesia using a laryngeal mask. Acta Otolaryngol. 2007;127:328-31 pubmed
    ..The LCA pulling method does not touch the posterior border of the thyroid cartilage so that the laryngeal mask does not disturb the arytenoid adducts. ..
  18. Rosen C, Gartner Schmidt J, Casiano R, Anderson T, Johnson F, Remacle M, et al. Vocal fold augmentation with calcium hydroxylapatite: twelve-month report. Laryngoscope. 2009;119:1033-41 pubmed publisher
    ..To evaluate the long-term effectiveness of calcium hydroxylapatite (CaHA) vocal fold injection for patients with glottal insufficiency...
  19. Bando H, Nishio T, Bamba H, Uno T, Hisa Y. Vocal fold paralysis as a sign of chest diseases: a 15-year retrospective study. World J Surg. 2006;30:293-8 pubmed
    ..Depending on the situation, chest x-ray is not enough for detecting the primary lesion. The objective of this study was to discuss the diagnostic procedure for VFP based on the retrospective analysis of the cases...
  20. Daya H, Hosni A, Bejar Solar I, Evans J, Bailey C. Pediatric vocal fold paralysis: a long-term retrospective study. Arch Otolaryngol Head Neck Surg. 2000;126:21-5 pubmed
    ..Recovery after an interval of up to 11 years was seen in idiopathic bilateral VFP; this has significant implications when considering lateralization procedures in these patients. ..
  21. Paniello R. Laryngeal reinnervation. Otolaryngol Clin North Am. 2004;37:161-81, vii-viii pubmed
    ..The historical and current perspectives on these techniques are discussed in this article. ..
  22. Zheng H, Zhou S, Li Z, Chen S, Zhang S, Huang Y, et al. [Reinnervation of the posterior cricoarytenoid muscle by the phrenic nerve for bilateral vocal cord paralysis in humans]. Zhonghua Er Bi Yan Hou Ke Za Zhi. 2002;37:210-4 pubmed
    ..To reestablish the respiratory abduction of the paralyzed vocal cord through reinnervation of the posterior cricoarytenoid(PCA) muscle by the phrenic nerve in humans...
  23. Maranillo E, Leon X, Ibanez M, Orus C, Quer M, Sanudo J. Variability of the nerve supply patterns of the human posterior cricoarytenoid muscle. Laryngoscope. 2003;113:602-6 pubmed
    ..The goal of the present study was to establish an accurate morphological description of the posterior cricoarytenoid muscle nerve supply in a large sample of human larynges...
  24. Shaw G, Pierce E. Malpractice litigation involving iatrogenic surgical vocal fold paralysis: a closed-claims review with recommendations for prevention and management. Ann Otol Rhinol Laryngol. 2009;118:6-12 pubmed
    ..Preoperative written information on potential complications, and early referral to and management by laryngeal specialists, we believe, may significantly reduce malpractice litigation. ..
  25. Dralle H, Sekulla C, Haerting J, Timmermann W, Neumann H, Kruse E, et al. Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery. 2004;136:1310-22 pubmed
    ..However, because of the overall low frequency of RLNP, no statistical difference compared with visual nerve identification only was reached in the setting of this study. ..
  26. Hiramatsu H, Tokashiki R, Yamaguchi H, Suzuki M, Ono H. Three-dimensional laryngeal model for planning of laryngeal framework surgery. Acta Otolaryngol. 2006;126:515-20 pubmed
    ..LCA pull surgery is a kind of arytenoid adduction for unilateral vocal cord paralysis. A three-dimensional model of case 1 larynx was prototyped using a selective laser sintering method...
  27. Yumoto E, Oyamada Y, Nakano K, Nakayama Y, Yamashita Y. Three-dimensional characteristics of the larynx with immobile vocal fold. Arch Otolaryngol Head Neck Surg. 2004;130:967-74 pubmed
  28. Kokotsakis J, Misthos P, Athanassiou T, Skouteli E, Rontogianni D, Lioulias A. Acute Ortner's syndrome arising from ductus arteriosus aneurysm. Tex Heart Inst J. 2008;35:216-7 pubmed
  29. Curtis R, Hahn C, Evans D, Williams T, Begg L. Thoracolaryngeal reflex latencies in Thoroughbred horses with recurrent laryngeal neuropathy. Vet J. 2005;170:67-76 pubmed
    ..Significant associations were found between reflex latencies and both horse age and the grade of RLN. Reflex latency measurements are reliable and sensitive, and may assist with the clinical appraisal of Thoroughbred horses with RLN. ..
  30. Bernstein J, Burrows S, Saunders M. Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis. Emerg Med J. 2007;24:e15 pubmed
    ..We recommend that in the absence of a history of observed ingestion, it should be assumed that coin-like foreign bodies are button batteries until proven otherwise. ..
  31. Laccourreye O, Papon J, Kania R, Crevier Buchman L, Brasnu D, Hans S. Intracordal injection of autologous fat in patients with unilateral laryngeal nerve paralysis: long-term results from the patient's perspective. Laryngoscope. 2003;113:541-5 pubmed
  32. Jeannon J, Orabi A, Bruch G, Abdalsalam H, Simo R. Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: a systematic review. Int J Clin Pract. 2009;63:624-9 pubmed publisher
    ..We propose establishment of a 'gold standard' for assessing the voice after thyroidectomy to reduce reporting bias. ..
  33. To W, Traquina D. Neuralgic amyotrophy presenting with bilateral vocal cord paralysis in a child: a case report. Int J Pediatr Otorhinolaryngol. 1999;48:251-4 pubmed
    Acute stridor and bilateral vocal cord paralysis is not uncommon in the neonate but is unusual in the older child...
  34. Duclos A, Touzet S, Soardo P, Colin C, Peix J, Lifante J. Quality monitoring in thyroid surgery using the Shewhart control chart. Br J Surg. 2009;96:171-4 pubmed publisher
    ..Complications almost doubled during a period when one surgeon was away and operating room renovations took place. Outcome monitoring in thyroid surgery using control charts is useful for identifying potential issues in patient safety. ..
  35. Radcliffe C, Woodie J, Hackett R, Ainsworth D, Erb H, Mitchell L, et al. A comparison of laryngoplasty and modified partial arytenoidectomy as treatments for laryngeal hemiplegia in exercising horses. Vet Surg. 2006;35:643-52 pubmed
    ..Both procedures diminish normal laryngeal protective mechanisms. At sub-maximal exercise intensities both LPVC and MPA restore airway ventilation to normal. At maximal exercise the superiority of LPVC over MPA is slight. ..
  36. Kanemoto N, Kanemoto K, Kamoda T, Hasegawa M, Arinami T. A case of Moebius syndrome presenting with congenital bilateral vocal cord paralysis. Eur J Pediatr. 2007;166:831-3 pubmed
    ..best of our knowledge, this is the first report of Moebius syndrome presenting with congenital bilateral vocal cord paralysis (CBVCP). Although CBVCP can be part of a recognizable syndrome, i.e...
  37. Katada A, Nonaka S, Adachi M, Kunibe I, Arakawa T, Imada M, et al. Functional electrical stimulation of laryngeal adductor muscle restores mobility of vocal fold and improves voice sounds in cats with unilateral laryngeal paralysis. Neurosci Res. 2004;50:153-9 pubmed
    ..We conclude that FES of the paralyzed laryngeal adductor muscle was effective in restoring adduction of the vocal fold and improving voice sounds impaired by unilateral laryngeal paralysis...
  38. Steurer M, Passler C, Denk D, Schneider B, Niederle B, Bigenzahn W. Advantages of recurrent laryngeal nerve identification in thyroidectomy and parathyroidectomy and the importance of preoperative and postoperative laryngoscopic examination in more than 1000 nerves at risk. Laryngoscope. 2002;112:124-33 pubmed
    ..Otherwise, the incidence of false-positive or false-negative diagnosis of RLNP is likely to be increased. ..
  39. Yumoto E, Sanuki T, Kumai Y. Immediate recurrent laryngeal nerve reconstruction and vocal outcome. Laryngoscope. 2006;116:1657-61 pubmed
    ..Immediate RLN reconstruction at the time of thyroid cancer extirpation can provide excellent postoperative phonatory function. ..
  40. Zealear D, Billante C, Courey M, Netterville J, Paniello R, Sanders I, et al. Reanimation of the paralyzed human larynx with an implantable electrical stimulation device. Laryngoscope. 2003;113:1149-56 pubmed
  41. Ducharme N, Cheetham J, Sanders I, Hermanson J, Hackett R, Soderholm L, et al. Considerations for pacing of the cricoarytenoid dorsalis muscle by neuroprosthesis in horses. Equine Vet J. 2010;42:534-40 pubmed publisher
    ..The minimal stimulation amplitude for maximal abduction angle is slightly higher than those for man and dogs. This treatment modality could eventually be applicable to horses with recurrent laryngeal neuropathy. ..
  42. Lee W, Milstein C, Hicks D, Akst L, Esclamado R. Results of ansa to recurrent laryngeal nerve reinnervation. Otolaryngol Head Neck Surg. 2007;136:450-4 pubmed
    ..We sought to describe the results of ansa cervicalis to recurrent laryngeal nerve (ansa-RLN) reinnervation for unilateral vocal fold paralysis...
  43. Barczynski M, Konturek A, Cichon S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg. 2009;96:240-6 pubmed publisher
    ..9 and 37.8 per cent respectively. Nerve monitoring decreased the incidence of transient but not permanent RLN paresis compared with visualization alone, particularly in high-risk patients. NCT00661024 (http://www.clinicaltrials.gov). ..
  44. San Luis Calo E, Ares Rodríguez X, Blanco Casais N, Masid Gómez A, Cortinas Diaz J, Alvarez Escudero J. [Utility of heliox during treatment of upper airway obstruction secondary to bilateral vocal cord paralysis after thyroidectomy]. Rev Esp Anestesiol Reanim. 2009;56:319-21 pubmed
    ..We report the case of a woman with severe upper airway obstruction due to bilateral vocal cord paralysis after thyroidectomy...
  45. Fang T, Lee L, Wang C, Li H, Chiang H. Intracordal fat assessment by 3-dimensional imaging after autologous fat injection in patients with thyroidectomy-induced unilateral vocal cord paralysis. Surgery. 2009;146:82-7 pubmed publisher
    Complications of thyroidectomy are the most frequent cause of unilateral vocal cord paralysis (UVCP) in Taiwan. Autologous fat injection for UVCP is a well-established procedure for temporary symptom relief...
  46. Liu S, Qiu M, Jiang D, Zheng X, Zhang W, Shen H, et al. The learning curve for endoscopic thyroidectomy: a single surgeon's experience. Surg Endosc. 2009;23:1802-6 pubmed publisher
    ..05). The first 60 cases constitute the early stage of the learning curve for endoscopic thyroidectomy. The proficiency and stability of the operation reach the advanced level after 150 cases. ..
  47. Paniello R, West S, Lee P. Laryngeal reinnervation with the hypoglossal nerve. I. Physiology, histochemistry, electromyography, and retrograde labeling in a canine model. Ann Otol Rhinol Laryngol. 2001;110:532-42 pubmed
    ..We conclude that the hypoglossal nerve functions well as a donor for adductory reinnervation of the larynx...
  48. Voigt D, Dollinger M, Yang A, Eysholdt U, Lohscheller J. Automatic diagnosis of vocal fold paresis by employing phonovibrogram features and machine learning methods. Comput Methods Programs Biomed. 2010;99:275-88 pubmed publisher
    ..The automatic Phonovibrogram analysis approach exceeded the experienced raters' classifications by 9%. The presented method holds a lot of potential for providing reliable vocal fold diagnosis support in the future. ..
  49. Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi P, et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg. 2004;28:271-6 pubmed
  50. Little M, Costello D, Harries M. Objective dysphonia quantification in vocal fold paralysis: comparing nonlinear with classical measures. J Voice. 2011;25:21-31 pubmed publisher
    ..We conclude that, when preanalysis editing is systematized, nonlinear random measures may be useful for monitoring UVFP-treatment effectiveness, and there may be applications to other forms of dysphonia. ..
  51. Lau D, Lee G, Wong S, Lim V, Chan Y, Tan N, et al. Injection laryngoplasty with hyaluronic acid for unilateral vocal cord paralysis. Randomized controlled trial comparing two different particle sizes. J Voice. 2010;24:113-8 pubmed publisher
    ..medialization in patients undergoing injection laryngoplasty (IL) with hyaluronic acid (HA) for unilateral vocal cord paralysis (UVCP)...
  52. Ahmed A, Williams D, Nicholson J. Vincristine-induced bilateral vocal cord paralysis in children. Pediatr Blood Cancer. 2007;48:248 pubmed
  53. Smith M, Roy N, Stoddard K. Ansa-RLN reinnervation for unilateral vocal fold paralysis in adolescents and young adults. Int J Pediatr Otorhinolaryngol. 2008;72:1311-6 pubmed publisher
    ..The procedure alleviates the disadvantages associated with other surgical options for this age group. ..