Damage to the laryngeal nerves can cause breathing and speaking difficulties. Causes include trauma, infection, tumors, and surgical complications. Diagnosis is made through imaging and endoscopy. Recovery is possible, but severe damage may require surgery and voice therapy.
The upper and lower laryngeal nerves in the throat control the movement and function of the larynx, also called the larynx. If one or both nerves are damaged due to trauma, infection, surgical complications, or other causes, significant difficulty breathing and speaking can occur. Laryngeal nerve damage is usually a minor problem that goes away on its own within a few months. In some cases, however, surgery is needed to repair severely damaged nerves and vocal cords. Patients may need voice therapy to regain the ability to speak clearly.
The larynx houses two bands of tissue called the vocal folds that stretch and compress to produce different pitches. The laryngeal nerves provide impulses from the brain to control their movement. The main consequence of damage to the laryngeal nerve is weakness or paralysis of the vocal cords. One or both cords can be affected, and depending on the severity of the nerve damage, the paralysis can be a temporary condition or cause lifelong speech difficulties.
Damage to the laryngeal nerve can have several causes. Direct trauma to the throat and chest can damage the larynx, windpipe, and underlying nerve tissue. People with chronic or recurring laryngitis may experience symptoms if swelling in the vocal cords puts pressure on the nerves. A cancerous or benign tumor can form in the windpipe which compresses the nerves and blood vessels in the area. Finally, some cases of damage to the laryngeal nerve occur as a result of surgery on the thyroid gland, windpipe, or other structure in the throat. Nerves are very delicate, and it is possible for a surgeon to accidentally touch or damage one during an operation.
Regardless of the cause, damage to the laryngeal nerve is likely to cause problems for patients. A person can be very hoarse and have noisy breathing. If speech is possible, it is usually in awkward tones and very quiet. An individual may also have difficulty swallowing food, drinking liquids, and clearing their throat. Breathing and swallowing difficulties can be severe enough to warrant an immediate trip to the emergency room.
After a patient’s breathing has stabilized, a doctor can diagnose damage to the laryngeal nerve by interpreting the results of diagnostic imaging scans. He or she tries to determine the extent of vocal cord damage and swelling and looks for signs of tumors, injuries, and infections. An endoscopic camera may be inserted down the throat to more closely inspect the nerves and voice box. The underlying causes are treated appropriately with medications or surgery.
Recovery is likely from minor nerve damage, and most patients simply need to rest for one to three months while nerve tissue heals. Significant damage may require surgery to preserve speech. The vocal cords can be realigned to promote clear, correctly pitched noises despite paralysis. Some voice problems can be permanent even with surgery, but regular sessions with speech therapists can help people learn to communicate effectively in their daily lives.
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