The superior and inferior laryngeal nerves in the throat control the movement and function of the larynx, also called the voice box. Significant breathing and speaking difficulties can arise if one or both nerves are damaged due to trauma, infection, surgical complications, or other causes. 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 their ability to speak clearly.
The larynx houses two bands of tissue called vocal cords that stretch and compress to produce different pitches. The laryngeal nerves supply impulses from the brain to control their movement. The major consequence of laryngeal nerve damage is weakness or paralysis of the vocal cords. One or both cords can be affected, and depending on the severity of nerve damage, paralysis can be a temporary condition or cause lifelong speech difficulties.
Laryngeal nerve damage can have several different causes. Direct trauma to the throat and chest can injure the larynx, trachea, and underlying nerve tissue. People with chronic or recurring laryngitis may experience symptoms if vocal cord swelling puts pressure on the nerves. A cancerous or benign tumor can form in the trachea that compresses nerves and blood vessels in the area. Finally, some cases of damage to the laryngeal nerve occur following surgery on the thyroid gland, trachea, or another structure in the throat. The nerves are very delicate and it is possible for a surgeon to accidentally sever or damage one during an operation.
Regardless of the cause, laryngeal nerve damage is likely to cause problems for patients. A person may be very hoarse and have noisy breathing. If speech is possible at all, it is usually at awkward pitches and very quiet. An individual may also have trouble swallowing food, drinking liquids, and clearing his or her throat. Breathing and swallowing difficulties can be severe enough to warrant an immediate trip to the emergency room.
After stabilizing a patient's breathing, a doctor can diagnose laryngeal nerve damage by interpreting results from diagnostic imaging scans. He or she tries to determine the extent of vocal cord damage and swelling and looks for signs of tumors, lesions, and infections. An endoscopic camera may be inserted into the throat to inspect the nerves and voice box more carefully. 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 surgical intervention to preserve speech. The vocal cords may be realigned to promote clear, properly-pitched noises despite paralysis. Some voice problems can be permanent even with surgery, but regular sessions with speech therapists can help people learn how to communicate effectively in their daily lives.