Paresis and Paralysis of the Larynx

Paresis and paralysis of the larynx

They arise as a result of inflammatory and degenerative processes in the muscles or dysfunction of the nerves innervating the larynx, brain centers and pathways.

Myopathic paresis or paralysis is caused by changes in the muscles of the larynx and is observed in acute and chronic laryngitis, some common infectious diseases (diphtheria, typhus, influenza, tuberculosis), and hemorrhage in the muscles of the larynx as a result of sudden overexertion of the voice. As a rule, they are bilateral, most often affecting the vocal muscles of the larynx.

Neuropathic paresis or paralysis can be of peripheral or central origin. Central paresis or paralysis more often occurs with bulbar tabetic lesions and hysteria. Peripheral paresis or paralysis depends on dysfunction of the branches of the vagus nerve.

The cause of dysfunction of these nerves can be injuries, various inflammatory, tumor and other pathological processes in the neck and chest.

Symptoms, course. Hoarseness up to aphonia.

Paralysis of the posterior cricoarytenoid muscle (the muscle that abducts the vocal fold outward and thereby opens the glottis) is of great practical importance. With acute bilateral paralysis of these muscles, the glottis does not open, and laryngeal stenosis occurs, requiring urgent tracheostomy. If the function of other muscles of the larynx is impaired, patients' complaints are reduced to a change in the character of the voice.

Diagnosis is made using laryngoscopy. By the appearance of the gap remaining between the vocal folds during phonation, it is possible to identify which muscle functions are impaired.

Treatment for myopathic paresis or paralysis of the larynx of inflammatory etiology is the same as for acute catarrhal laryngitis. In addition, physiotherapy is used: electrophoresis, diathermy.

For neuropathic paresis or paralysis of the larynx, treatment of a disease that has caused disruption of the innervation of the larynx is indicated.