Laryngeal Nerve Palsy or Paralysis (Anatomy, physiology, classification, causes, pathophysiology)

Laryngeal nerve palsy usually refers to the palsy of the recurrent largyngeal nerve. The recurrent laryngeal nerve is responsible for both abduction (opening) and adduction (closing) of the vocal fold. Therefore recurrent laryngeal nerve palsy is also called vocal cord paralysis and may be the first presentation of severe pathology such as cancer. People often present with hoarseness, coughing and exertional dyspnea. The vagus nerve runs a complex course. The vagus nerve exits the brainstem and descends and supplies and innervates many organs including the heart, lungs and gastrointestinal tract. The right and left vagus nerve descends along the trachea behind the common carotid artery. As the vagus nerve descends down it gives off a few branches; the superior laryngeal nerve which branches into the external and internal laryngeal nerves. The external laryngeal nerve supplies the cricothyroid muscle, the tuning fork of the larynx, responsible for raising pitch.The internal laryngeal nerve is responsible for sensation of the larynx above the vocal cords.