Complete paralysis of a vocal cord occurs when both the superior and recurrent laryngeal nerves are affected on the same side.
A single lesion capable of damaging both nerves is typically located proximal to the nodose ganglion. The presence of multiple lesions can also affect both nerves.
The paralysis affects all laryngeal muscles, including the cricothyroid (which is spared if the recurrent laryneal nerve alone is injured).
On laryngoscopy the affected vocal cord is fixed in the cadaveric position (in-between fully open and closed).
Clinical Finding
Unilateral
Bilateral
voice
weak, hoarse
very weak to absent, unable to alter pitch
cough
decreased
weak and ineffective
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