Treatment of paresis of the larynx

Laryngeal paresis is a disease that can significantly reduce the quality of life of any person. It deprives the patient of such simple pleasures as free breathing, enjoying delicious food, actively participating in conversation, singing, etc. The causes of this disease are many, and the prognosis of treatment is not always favorable. What is laryngeal paresis, and how to protect yourself from it?

Paresis and paralysis of the larynx are a group of diseases based on the disruption of the muscles of the larynx, primarily the vocal cords.

This condition occurs when a nerve impulse, for some reason, cannot reach the muscles and set them in motion. As a result, the muscles are immobilized, i.e. paralyzed.

Let's talk in more detail about how this disease develops and how to treat it.

What is paresis and paralysis of the larynx?

The vocal cords are two muscle groups located in the larynx. When a person talks, these muscles contract and vibrate. Contraction is an active process controlled by the brain, and vibration occurs under the influence of the flow of air passing through the larynx. When a person is silent, the vocal cords are relaxed. They are in a position that allows air to pass freely through the respiratory tract.

If the innervation of the muscles is impaired, they can no longer contract. A person cannot use a paralyzed muscle, as a result of which there are difficulties with speech. In addition, a paralyzed muscle often interferes with the flow of air. This is paresis, or paralysis of the vocal cords.

The terms paresis and paralysis are often used interchangeably. However, these concepts are somewhat different from each other.

Paralysis refers to a complete loss of movement, while paresis refers to a partial loss of motor function of the vocal cords.

So, paresis of the larynx does not significantly impair the functions of the larynx. In most cases, with paresis, speech is slightly impaired, but this does not greatly affect the patient's quality of life. However, for people whose work is connected with the need to speak constantly and clearly (announcers, commentators, singers), paresis can become a serious problem.

If we talk about paralysis of the larynx, this disease leads to more serious consequences - for example, immobility of the muscles does not allow a person to speak normally, and in some cases even breathe.

What are the reasons?

As already noted, the pathogenesis of the disease is based on a violation of muscle innervation. But why is this failure happening? It is known that the following factors contribute to this pathological process:

1. Surgical interventions

Indeed, a factor that significantly increases the risk of developing paresis is the transfer of surgery on the organs of the neck or chest (on the thyroid gland, lungs, esophagus, as well as the trachea and larynx).

1. Intubation of the trachea or larynx

Intubation refers to the insertion of an elastic tube into the trachea or larynx to maintain breathing in a person under the influence of anesthesia. Also, intubation is used for stenosis of the larynx, to ensure the passage of air through the respiratory tract. It is worth noting that intubation leads to disruption of the larynx very rarely - otherwise complications would develop in most patients undergoing general anesthesia.

1. Trauma

Any injury to the neck and chest could potentially damage the vagus nerve that innervates the larynx.

1. Neoplasms

Both cancerous and benign tumors of the base of the skull, neck and chest can grow around the nerves, compressing them, resulting in varying degrees of paresis.

1. Infections

Inflammation that accompanies any infection can lead to disruption of the vagus nerve or its branches. It is known that viral infections affecting the larynx have the greatest impact.

1. Neurological causes of laryngeal paralysis

People suffering from various neurological diseases, such as multiple sclerosis, Parkinson's disease, etc., may experience a violation of the innervation of the muscles of the larynx. Laryngeal paresis can also develop in the immediate family of neurological patients.

Symptoms

The larynx is a multifunctional organ. He participates in the process of breathing, swallowing food, and the formation of speech sounds. That is why a violation of the innervation of the larynx leads to many violations related to the performance of these functions.

Signs that the innervation of the muscles in the larynx is impaired:

1. Voice change - it can become hoarse, quieter, thinner, etc. Many patients have a feeling of discomfort when talking - in order to pronounce a word, they must make an effort, take more air into their lungs, etc. While talking, the patient is forced to pause to take a deep breath. The ability to speak loudly is completely lost.
2. Breathing problems - shortness of breath occurs during physical exertion, noisy breathing, constant dry cough worries.
3. Violation of the act of swallowing - when swallowing food, water or even saliva, a cough often appears. In addition, mucus builds up in the throat as the patient cannot swallow it effectively.
4. In severe, advanced cases - shallow breathing, weakness, apathy, slow heart rate, weight loss, poor resistance to infectious diseases of the respiratory system.

If you are concerned about a sudden change in voice, persistent hoarseness, an unreasonable cough, or any of the above symptoms for two weeks or more, see your doctor.

Diagnostics

When heading to the clinic, you should be prepared for the fact that some examinations will be required to make a diagnosis and prescribe treatment.

First, the doctor will ask you about how long you have been experiencing problems with your voice, what other symptoms you have been experiencing. Also, for the delivery of the diagnosis, you need to know whether you smoke, whether you have undergone surgery, whether you suffer from neurological disorders, etc.

The following tests may be needed to further assess the condition of the larynx:

1. Laryngoscopy. The doctor examines the vocal cords using a laryngoscope or endoscope. During the study, the doctor determines the degree of paralysis of the vocal cords, their position in the larynx, and also determines whether one group of vocal muscles is affected, or both.
2. Laryngoelectromyography. This test measures the electrical impulses that travel to the muscles in the larynx from the brain. During the test, the doctor will ask the patient to perform actions that normally activate the flow of nerve impulses to the vocal cords (say something in a whisper, sing, etc.). Laryngoelectromyography provides information on how effectively the vocal cords can heal during treatment. If extremely weak impulses enter the muscles, treatment may be ineffective.
3. Various blood tests (biochemical, clinical, etc.) are used to find out the causes of the development of paralysis.
4. Ultrasounds, chest x-rays, and other similar tests are used to rule out the presence of tumors and other growths in the neck, chest, and head.

The examination will help not only to find out the cause of the disease, but also to make predictions about the further course of the disease, draw up a treatment plan, and select the necessary medications.

Treatment

Treatment for paralysis and paresis of the vocal cords depends on the cause of the disease, the severity of the symptoms, and the time elapsed from the onset of the first symptoms.

• Voice therapy

Voice therapy sessions, or phonopedics as it is also called, include breathing exercises, singing and other activities aimed at strengthening the vocal cords, as well as developing control over the breathing process. This prevents overstraining of the muscles around the paralyzed vocal cord and also protects the airway when swallowing. If laryngeal paresis affects a small group of vocal cords, voice therapy may be the only treatment. In other cases, phonopedia plays the role of adjuvant therapy.

• Drug treatment

The choice of drugs that eliminate paralysis of the larynx is strictly individual, and depends, first of all, on the root cause of the disease. So, the patient can be prescribed antihistamines, corticosteroids, antipsychotics, muscle relaxants, etc.

In parallel with taking drugs, it is recommended to undergo a course of electrical stimulation of the nerves and muscles of the larynx.

• Surgery

Surgery is usually used when other types of treatment have failed. There are several types of surgery that can eliminate laryngeal paralysis:

• Injections of fillers such as collagen (to keep the vocal cords in a normal position)
• placement of an implant (the action is similar to injections, but gives a more long-term effect);
• transplantation of a damaged nerve (reinnervation) - another nerve of the same person is transplanted in place of the damaged nerve;
• thyroplasty is a surgical correction of the larynx that changes the location of the vocal cords.

Each of the operations has its own advantages and disadvantages. The choice of surgery depends on the individual characteristics of the patient and is determined by the attending physician.

After the operation, you should not expect a sharp improvement - it will take several months to restore the normal functioning of the vocal cords.