Symptoms from RLN damage Symptoms from SLN damage * Rough voice quality * Breathy voice quality * Vocal fold bowing * Decreased vocal fold mobility * Glottal insufficiency * Hyperfunction * Vocal fatigue * Reduced vocal stamina * Changes in voice pitch or pitch range * Difficulty varying pitch at a quick rate * Difficulty projecting voice or speaking loudly or in noisy environments * Throat pain * Bouts of choking * Diplophonia * Swallowing difficulties * Chronic coughing * Globus sensation * Hypersensitivity or abnormal sensation * Vocal fold spasms * Pain from vocal use * Loss of voice in high pitch ranges Typically, patients with vocal fold<unk>  or paralysis are able to identify the onset of their symptoms. The most commonly reported symptom patients with either vocal fold<unk>  or paralysis make is having a rough voice quality. It is important to note that the symptoms of vocal fold<unk>  are not specific to the condition and tend to be common symptoms of other voice disorders as well. Vocal fold bowing, decreased vocal fold mobility, especially decreased mobility of the arytenoid cartilage, are often observed in vocal fold<unk> . Glottal insufficiency is another common symptom observed in vocal fold<unk> . In this case, the vocal folds do not come together properly. Glottal insufficiency may be hard to identify, especially when the area above the vocal folds is hyperfunctional. Hyperfunction may also make it difficult to detect the presence of vocal fold<unk> . Hyperfunction of the area above the vocal folds may be considered a sign of glottal insufficiency and potentially, vocal fold<unk> . In some cases, glottal closure may appear to be normal, however, asymmetries in the vocal folds may still be present. Though voice qualities may appear normal in some cases of vocal fold<unk>  or paralysis, mild differences in tension between the two vocal folds of the larynx can result in changes of voice pitch, intensity and reduced vocal stamina. Patients with either vocal fold<unk>  or paralysis may exhibit a breathy voice quality. This voice quality results from the increased activity of the vocal folds to compensate for the immobility of the PCA muscle(s). Patients may need to use more effort than normal when speaking and may find that their voice quiets or grows tired after speaking for a long time. This is known as vocal fatigue. Patients may also complain about having a limited pitch range and trouble varying their pitch at quick rate. It is often difficult for the speaker to project their voice and speak loud enough to be heard in noisy environments, over background noise, or when speaking to someone from a distance. It is possible for symptoms to surface only in situations where the environmental acoustics are poor, such as outdoors. Patients may report feeling pain in the throat or experiencing bouts of choking. A patient presenting with diplophonia is of major concern as this typically means that the mass and tension of their vocal folds are asymmetrical which may also indicate vocal fold<unk> . Swallowing difficulties (dysphagia) are not commonly seen in vocal fold<unk>  that results from RLN damage. Dysphagia may however, suggest SLN damage. Symptoms of sensory nerve damage include: chronic coughing, the feeling of having a lump in the throat (globus sensation), hypersensitivity or abnormal sensation, spasms of the vocal folds (laryngospasms), dysphagia, pain from vocal use, and voice loss in high pitch ranges. It is possible for both the RLN and the SLN to be damaged simultaneously, so the symptoms of RLN and SLN damage may be seen independently or alongside one another. If maladaptive compensatory strategies are used more and more to try to offset the voice difficulties, the vocal mechanisms will fatigue and the above symptoms will worsen.
Vocal cord paresis
Vocal cord dysfunction
Facial nerve paralysis
Oropharyngeal dysphagia
Laryngotracheal stenosis
Laryngomalacia
Tracheal deviation
Glossoptosis