Vocal Rehabilitation of Paralytic Dysphonia: I. Cartilage Injection into a Paralyzed Vocal Cord

Abstract

FUNCTIONAL EFFECTS OF LARYNGEAL PARALYSIS The larynx serves several functions: (1) sphincter action for the protective or reflectory occlusion of the airways; this is needed for deglutition, expectoration, defecation, and physical exertion; (2) respiratory abduction of the vocal cords for the opening of the airways during breathing; (3) phonatory adduction of the vocal cords for the intonation of voice (phonation). Hence, laryngeal paralysis may disturb each or all of these functions. The effects of paralytic disability naturally depend on the type of paralysis. As is well known, laryngeal paralysis may be unilateral or bilateral, partial or complete, and it may disturb abduction or adduction. Abductor paralysis immobilizes the cord in the paramedian line. The resulting obstruction to respiration is moderate in paralysis of one cord, while bilateral paralysis causes severe dyspnea. Phonation, on the other hand, is but slightly disturbed because the paralyzed cord always remains in the position of