J38.02 Paralysis of vocal cords and larynx, bilateral

Name of the Condition

• Paralysis of Vocal Cords and Larynx, Bilateral

Summary

Paralysis of the vocal cords and larynx, bilateral, occurs when both sides of the larynx lose motor function, impairing voice production, airway protection, and breathing. This condition disrupts the coordinated movement of the vocal cords, which are essential for speech, swallowing, and maintaining an open airway.

Causes

Nerve damage from surgery, trauma, or injury to the neck, chest, or thyroid region. Neurological conditions such as stroke, multiple sclerosis, or Parkinson’s disease. Tumors or masses compressing the nerves supplying the larynx. Viral infections affecting the vagus or recurrent laryngeal nerves.

Risk Factors

• History of neck, chest, or thyroid surgery.
• Neurological disorders or prior stroke.
• Smoking or exposure to respiratory irritants.
• Age-related degeneration of nerve or muscle function.

Symptoms

• Hoarse, breathy, or weak voice.
• Difficulty swallowing (dysphagia) or choking on food/liquids.
• Shortness of breath, especially during exertion or speech.
• Loss of vocal pitch or inability to speak loudly.

Diagnosis

Diagnosis involves a combination of clinical evaluation and specialized tests. Laryngoscopy is used to assess vocal cord movement, while electromyography (EMG) evaluates nerve and muscle function. Imaging studies like CT or MRI may identify underlying structural or neurological causes.

Treatment Options

• Voice Therapy: Exercises to improve voice quality and function.
• Surgery: Procedures to reposition or bulk up the affected vocal cord.
• Tracheotomy: In severe cases, to assist with breathing.

Prognosis and Follow-Up

Prognosis depends on the underlying cause and severity. Many individuals recover vocal function with therapy and time. Regular follow-ups may include voice assessments and monitoring for airway complications.

Complications

• Chronic aspiration or pneumonia due to swallowing difficulties.
• Persistent breathing difficulties requiring long-term airway support.
• Permanent voice changes affecting communication.

Lifestyle & Prevention

• Avoid smoking and exposure to respiratory irritants.
• Manage underlying conditions like GERD or neurological disorders.
• Use proper vocal hygiene to reduce strain.

When to Seek Professional Help

Seek medical attention if you experience sudden voice changes, difficulty swallowing, or breathing problems. Prompt evaluation is important to address potential airway obstruction.

Tips for Medical Coders

Document the bilateral nature of the paralysis and any associated symptoms or underlying causes. Ensure clinical notes support the diagnosis and specify whether the condition is acute or chronic.