(05-21-2019, 01:44 PM)crowtor Wrote: Stridor is common with patients with partial or full vocal cord paralysis, and is mistaken as snoring, obstructive events.
A half treatment is baloon endoscopy that dilates any narrowing that may be present, another, scaring the tissue to make it more rigid etc. I'd personally sacrifice being able to speak for a night of good sleep without choking.
Yep, seems that most docs and ENT's have a basic understanding of vocal cord paralysis, but the subtleties sometimes escape them. My primary care physician simply would not believe that I have a paralyzed vocal cord. He literally said "I don't believe you have a paralyzed vocal cord. You voice is perfectly fine!" I told him it had been confirmed by Wake Forest, Vanderbilt, Mayo, and others as well as several laryngoscopies. His response was, "I'll need more proof than your opinion of what you think is going on." So anyway, the paralysis I have effects the abductor (opening the cord) of the left cord. So when I inhale the flow is less than half a normal person because the cord is not getting out of the way. This isn't a problem in normal activities or even talking (the right cord moves against the paralyzed left to make normal sounds). The problems occur with exercises like running where high flow rates are required to maintain levels of activity. I can run, swim, etc. but my speed needs to be slow because I can't move enough air. Sleeping is a problem, but CPAP helps and I use that regularly to good effect.
The issue I'm concerned with now (aside from my poor athletic performance) is that with and sometimes without the CPAP I am making vocal sounds (i.e. through the vocal cords). This has slowly increased over the last year. If I nod off without CPAP, I am immediately awakened by my own voice. My ENT says that right (non paralyzed cord) may be weakening or the paralyzed cord may be flopping toward the good one when I'm in a sleep state. It could be physiologic or neurologic such as a failing autonomic function (nerve signal) not stimulating full abduction when I sleep. The way to compare wake and sleep vocal fold function is via the DISE procedure.
Either way there are options ranging from cordectomy (cutting a slit in the vocal cords for greater flow) to implanted electro stimulator (like a pacemaker for the cords) to laryngeal reinnervation surgery performed at Mayo (Rochester) and a few other centers.
So the emerging great new options and determination of autonomic function are why I am interested in pursuing DISE. I would love to have more or restored vocal cord movement. Here are some explanatory links:
https://www.mayoclinic.org/medical-profe...c-20431242
Caution, this a graphic, real surgical procedure for reinnervation:
https://www.youtube.com/watch?v=_aoUbRXBxDI