Recurrent laryngeal nerve paresis

Nervus laryngeus recurrens sensitively innervates the subglottic part of the larynx and motorically all muscles of the larynx except the cricothyroideus muscle.

Paresis of the recurrent laryngeal nerve can occur:
 * Damage to the nuclei of the vagus nerve;
 * By damage to the vagus nerve above the recurrent laryngeal nerve – tumor, trauma, neurological disease, skull base surgery;
 * Damage to recurrent laryngeal nerve – neck surgery, upper mediastinal surgery and especially thyroid surgery.

Unilateral paresis

 * Unilateral paresis is manifested by a phonation disorder. Inspiratory dyspnea is not present.
 * The vocal cord becomes immobile, it is fixed in the paramedian position.
 * Therapy: phoniatric care - in case of failure, surgery (thyreoplasty) comes next.

Bilateral paresis

 * Bilateral paresis leads to airway stenosis in the glottis region.
 * It is clinically manifested by dysphonia, dysphagia and inspiratory dyspnea with inspiratory stridor.
 * The vocal cords are immobile, fixed in a paramedian position.
 * Therapy: provision of airways, widening of the respiratory slit (laterofixation of the vocal cords, arytenoidectomy, chordectomy).

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