Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box.

Injury to the laryngeal nerves is uncommon.

However, it may occur from:

• A complication of neck or chest surgery (especially thyroid, lung, or heart surgery)
• A breathing tube in the windpipe (endotracheal tube)
• Tumors in the neck or upper chest, such as thyroid or lung cancer

• Difficulty speaking
• Difficulty swallowing
• Hoarseness

Injury to the left and right laryngeal nerves at the same time is an urgent situation that can lead to difficulty breathing.

The doctor will see if the vocal cords move abnormally. Abnormal movement usually means that a laryngeal nerve is injured.

Tests may include:

• Bronchoscopy
• CT scan of the chest
• Laryngoscopy
• X-ray

Treatment depends on the cause of the injury. In some instances, no treatment may be needed and the nerve may recover on its own. Voice therapy is useful in some cases.

If surgery is needed, the goal is to change the position of the paralyzed vocal cord to improve the voice. This can be done with:

• Arytenoid adduction
• Injections of collagen, Gelfoam, or some other substance
• Thyroplasty

If both left and right nerves are damaged, a hole may need to be cut into the windpipe (tracheotomy) immediately to allow breathing. This is followed by another surgery at a later date.

The outlook depends on the cause of the injury. In some cases, the nerve rapidly returns to normal. However, sometimes the damage is permanent.

Call your health care provider if you have:

• Difficulty breathing
• Unexplained hoarseness that lasts for more than 3 weeks