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Laryngeal nerve damage

Alternative names

Vocal cord paralysis


Damage to one or both of the nerves attached to the larynx (voice box) can result in loss of voice or obstruction of breathing. Damage to the recurrent laryngeal nerve is especially common during thyroid, lung, or heart surgery.

Causes, incidence, and risk factors

Injury to the recurrent laryngeal nerve is uncommon but may occur as a complication of surgery in the neck or chest. It may also occur from the placement of a breathing tube in the windpipe (endotracheal tube) or during positioning of the head and neck prior to the placement of such a tube. The nerve can also be injured by masses (tumors) or swollen lymph nodes in the mediastinum (center of the chest).


Hoarseness and difficulty speaking are the most common symptoms. Difficulty swallowing may also occur.

Signs and tests

Abnormal motion of the vocal cords usually results from injury to the recurrent laryngeal nerve. This can be seen directly during laryngoscopy or bronchoscopy (the passage of a thin tube with a camera on the end into the airways). An X-ray or CT scan of the chest may be done to detect any abnormalities in the mediastinum that might be responsible for the injury.


Treatment depends on the cause of the injury. In some instances, no treatment may be required and the nerve may recover on its own.

Expectations (prognosis)

The prognosis depends on the cause of the injury. In some cases, the nerve rapidly returns to normal. However, sometimes the damage is permanent.


Occasionally, injury to the recurrent larygneal nerve may lead to difficulty breathing.

Calling your health care provider

Call your health care provider if you have unexplained hoarseness that persists for a long time, or if you have difficulty breathing.

Update Date: 2/6/2003

David A. Kaufman, M.D., Pulmonary & Critical Care Medicine, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT