LIV Paralysis of the Larynx

Paralysis of a vocal cord usually is secondary to a lesion of a peripheral nerve. Central lesions account for about 10%) of cases. Peripheral lesions may involve the vagus nerve at the jugular foramen, the superior laryngeal branch in the neck and the recurrent or inferior laryngeal branch in the neck or mediastinum. While the causes are numerous there is common agreement that malignant growths exclusive of laryngeal neoplasms, trauma to a nerve in the course of surgical treatment of disease of the thyroid gland and aneurysm of the aorta are the most frequent. Agreement, however, is not unanimous on the innervation of the larynx, the position assumed by the vocal cord immediately following injury to the recurrent nerve and the changes that occur subsequently depending on whether there is complete and permanent loss or restoration of laryngeal function. In this paper an attempt will be made to correlate the experimental and anatomical findings of certain investigators with clinical observations made in a group of over 250 cases of laryngeal paralysis of peripheral origin.