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Laryngeal paralysis (laryngeal paresis) - Symptoms
Last reviewed: 04.07.2025
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Laryngeal paralysis is characterized by immobility of one or both halves of the larynx. Disruption of innervation entails serious morphofunctional changes - the respiratory, protective and voice-forming functions of the larynx suffer.
Central paralysis is characterized by impaired mobility of the tongue and soft palate, and changes in articulation.
The main complaints with unilateral laryngeal paralysis:
- aspirated hoarseness of varying severity;
- shortness of breath, which increases with vocal exertion;
- choking;
- pain and a sensation of a foreign body on the affected side.
In case of bilateral laryngeal paralysis, the clinical symptoms of its stenosis come to the fore.
The degree of expression of clinical symptoms and morphofunctional changes in the larynx during paralysis depends on the position of the paralyzed vocal fold and the duration of the disease. A distinction is made between the median, paramedian, intermedian and lateral positions of the vocal folds.
In case of unilateral laryngeal paralysis, the clinical picture is most vivid with the lateral position of the paralyzed vocal fold. With median - symptoms may be absent, and the diagnosis is established accidentally during a routine examination. Such laryngeal paralysis accounts for 30%. For bilateral lesions with lateral fixation of the vocal folds, aphonia is characteristic. Respiratory failure develops according to the type of hyperventilation syndrome, a violation of the dividing function of the larynx is possible, especially in the form of choking on liquid food. With bilateral paralysis with paramedian, intermedian position of the vocal folds, respiratory function is impaired up to third-degree laryngeal stenosis, requiring immediate surgical treatment. It should be remembered that with bilateral lesions, the better the patient's voice, the worse the respiratory function.
The severity of clinical symptoms also depends on the duration of the disease. In the first days, there is a violation of the dividing function of the larynx, shortness of breath, significant hoarseness, a sensation of a foreign body in the throat, and sometimes a cough. Later, on the 4th-10th day and at later dates, there is an improvement due to partial compensation for lost functions. However, in the absence of therapy, the severity of clinical manifestations may increase over time due to the development of atrophic processes in the muscles of the larynx, worsening the closure of the vocal folds.
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