Recurrent laryngeal nerve paresis

Nervus laryngeus recurrentens 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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