Vocal Cord Immobility: Central Origin
Vocal cord immobility of central origin, mainly as unilateral or less frequently as bilateral vocal cord palsy, is a rare symptom considering the incidence of central nervous system diseases. Theoretically, any cerebral or cerebellar disease affecting motor neurons or motor neuron pathways that are involved in laryngeal muscle movement may lead to vocal cord palsy. The most important causes are stroke, Parkinson’s disease, and multiple system atrophy. These diseases and characteristic laryngeal findings are presented in detail in this chapter. The differentiation of vocal cord immobility of central origin and diseases like essential voice tremor and laryngeal dystonia is explained. Finally, a subchapter deals with the special situation of congenital vocal cord immobility of central origin. Treatment is dominated by the treatment of the underlying neurological disease. Nevertheless, as in vocal cord immobility of peripheral origin, modern phonosurgery plays an important role in the curative or palliative care of these patients.
KeywordsVocal cord paralysis Laryngology Stroke Parkinson’s disease Central nervous system
The video shows the FEES of a patient with a stroke. Penetration and retention of saliva in the sinus piriformis and the valleculae can be observed. When swallowing blue-colored paste, the penetration and retention in the sinus piriformis and the valleculae become more obvious. Also a hypomobility of the left vocal fold can be observed (WMV 6378 kb)
The video shows the FEES of another patient with a stroke. Penetration and retention of saliva in the sinus piriformis and the valleculae can be observed. When swallowing blue-colored liquid, not only the penetration and retention in the sinus piriformis and the valleculae but also aspirations are detected (WMV 5472 kb)
- 7.Altman KW, Schaefer SD, Yu GP, Hertegard S, Lundy DS, Blumin JH, et al. The voice and laryngeal dysfunction in stroke: a report from the neurolaryngology subcommittee of the American academy of otolaryngology-head and neck surgery. Otolaryngol Head Neck Surg. 2007;136(6):873–81.CrossRefPubMedGoogle Scholar