Treatment Options for Unilateral Vocal Cord Paralysis After Thyroid Surgery

Q: Treatment Options for Unilateral Vocal Cord Paralysis After Thyroid Surgery

Hello： In response to your question, your issue may be caused by damage to the left recurrent laryngeal nerve. <br>Further examination and evaluation may be necessary in an outpatient setting.

Unilateral vocal cord paralysis

Hello Dr.
Hsu, I underwent thyroid surgery in July 2001, and after the surgery, I discovered that I have left vocal cord paralysis, which has caused difficulty in speaking and choking while eating and drinking.
Are there any treatment options available to restore vocal cord function?

Xinhuanren, 30~39 year old female. Ask Date: 2003/03/10

Dr. Xu Jiazhen reply Otolaryngology

Hello: In response to your question, your issue may be caused by damage to the left recurrent laryngeal nerve.
Further examination and evaluation may be necessary in an outpatient setting.

Reply Date: 2003/03/10

More Info

Unilateral vocal cord paralysis (UVCP) following thyroid surgery is a recognized complication that can significantly affect a patient's quality of life. The vocal cords, or vocal folds, are essential for phonation (voice production) and protecting the airway during swallowing. When one vocal cord is paralyzed, it can lead to voice changes, difficulty swallowing, and an increased risk of aspiration, which can result in choking or respiratory complications.

Treatment Options for Unilateral Vocal Cord Paralysis
1. Voice Therapy: The first line of treatment for UVCP is often voice therapy, which is conducted by a speech-language pathologist. This therapy focuses on improving vocal function through exercises that strengthen the remaining vocal cord and optimize voice production. Techniques may include breath control, pitch modulation, and resonance training.

2. Surgical Interventions:
- Medialization Laryngoplasty: This surgical procedure involves placing an implant or using sutures to push the paralyzed vocal cord closer to the midline of the larynx. This helps improve voice quality and airway protection during swallowing.

- Arytenoid Adduction: In this procedure, the arytenoid cartilage (which helps control vocal cord movement) is repositioned to bring the paralyzed vocal cord closer to the other functioning vocal cord. This can enhance voice quality and reduce aspiration risk.

- Reinnervation Procedures: In some cases, surgical techniques may be employed to restore nerve function to the paralyzed vocal cord. This is a more complex procedure and is typically considered when other treatments have failed.

3. Observation: In some cases, especially if the paralysis is recent, doctors may recommend a period of observation. Some patients experience spontaneous recovery of vocal cord function within a few months post-surgery.

4. Aspiration Management: If swallowing difficulties are present, strategies such as dietary modifications, swallowing therapy, or the use of thickening agents for liquids may be recommended to reduce the risk of aspiration.

5. Botulinum Toxin Injections: In certain cases, botulinum toxin may be injected into the vocal cord to help improve voice quality by temporarily paralyzing the opposing vocal cord, allowing for better closure during phonation.

Follow-Up and Monitoring
Regular follow-up with an otolaryngologist (ENT specialist) is crucial for monitoring the condition and adjusting treatment as necessary. If voice therapy is initiated, progress should be evaluated periodically to determine its effectiveness and whether surgical options should be considered.

Conclusion
If you are experiencing significant voice changes and swallowing difficulties following your thyroid surgery, it is essential to consult with your healthcare provider or an ENT specialist. They can assess your specific situation and recommend the most appropriate treatment options based on the severity of your symptoms and the duration of your vocal cord paralysis. Early intervention can lead to better outcomes, so do not hesitate to seek help.

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