Overview
Introduction
Vocal cord (vocal fold) paralysis is loss of movement in one or both folds, usually from dysfunction of the recurrent laryngeal nerve or the vagus nerve pathway.
Vocal cord (vocal fold) paralysis is loss of movement in one or both folds, usually from dysfunction of the recurrent laryngeal nerve or the vagus nerve pathway. The first bedside distinction is unilateral versus bilateral disease. One immobile fold commonly produces a weak, breathy voice and incomplete airway protection during swallowing; two immobile folds can narrow the inspiratory airway and cause stridor. Hoarseness after thyroid or neck surgery warrants assessment, but stridor, increasing work of breathing, or hypoxemia changes the priority to emergency airway management. Laryngoscopy establishes whether the folds move, while imaging helps identify the lesion along the nerve’s course. Nursing care therefore links voice assessment with airway triage, swallowing safety, and a plan for recovery or communication support.