The vagus nerve originates in the lower portion of the brainstem. It exits the brain and passes along with the carotid artery and jugular vein in the neck. The recurrent laryngeal nerve wraps around either a major vessel or a rudimentary vessel and then ascends back into the neck where it is the primary nerve supply for the muscles of the larynx and vocal cords. It is necessary to differentiate where the nerve is affected. When the intracranial part is involved, there are often other signs , such as multiple cranial nerve palsies, incoordaination, weakness, etc. If the person cannot shrug the shoulder, if there is numbness of the palate and difficulties with movement of the tongue, the nerve is probably affected at the bottom of the skull or shortly after it exits.
Causes of Recurrent Laryngeal Nerve Palsy
The recurrent laryngeal nerves are most commonly damaged in the chest. Disease of the major blood vessels, such as aneurysm, tumors of the mediastinum, or enlargement of the upper portion of the heart, can stretch the nerve. The nerve can be injured in the neck from surgery or trauma.
Signs and Symptoms of Recurrent Laryngeal Nerve Palsy
When the recurrent laryngeal nerve is injured alone, it produces paralysis of one vocal cord. This leads to hoarseness. There may be problems with the airway. Aspiration may occur, leading to cough, chest pain, fever and chills. Aspiration may also produce shortness of breath. There is no sensory loss in the throat when the nerve is injured at the level of the recurrent laryngeal nerve.
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Medical Content Last Updated on 07/12/2008
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