Laryngeal nerve damage
Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box.
Vocal cord paralysis
Causes, incidence, and risk factors
Injury to the laryngeal nerves is uncommon.
It it does occur, it can be from:
- A complication of neck or chest surgery (especially thyroid, lung, heart surgery, or cervical spine surgery)
- A breathing tube in the windpipe (endotracheal tube)
- A viral infection that affects the nerves
- Tumors in the neck or upper chest, such as thyroid or lung cancer
- Difficulty speaking
- Difficulty swallowing
Injury to the left and right laryngeal nerves at the same time can be an urgent situation that can lead to difficulty breathing.
Signs and tests
The doctor will check if your vocal cords move abnormally. Abnormal movement may mean that a laryngeal nerve is injured.
Tests may include:
Treatment depends on the cause of the injury. In some instances, no treatment may be needed and the nerve may recover on its own. Voice therapy is useful in some cases.
If surgery is needed, the goal is to change the position of the paralyzed vocal cord to improve the voice. This can be done with:
- Arytenoid adduction (stitches to move the vocal cord toward the middle of the airway)
- Injections of collagen, Gelfoam, or another substance
If both the left and right nerves are damaged, a hole may need to be cut into the windpipe (tracheotomy) right away to allow breathing. This is followed by another surgery at a later date.
The outlook depends on the cause of the injury. In some cases, the nerve rapidly returns to normal. However, sometimes the damage is permanent.
Calling your health care provider
Call your health care provider if you have:
- Difficulty breathing (call right away)
- Unexplained hoarseness that lasts for more than 3 weeks
Lai SY, Mandel SJ, Weber RS. Management of thyroid neoplasms. In: Cummings CW, Flint PW, Haughey BH, et al., eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 124.
Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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