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Valentina Carlile Osteopata
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Osteopathy and Voice: unilateral chordal paralysis after thyroidectomy – clinical case

Osteopathy and Voice: unilateral chordal paralysis after thyroidectomy – clinical case

The recurrent laryngeal nerve (RLN) is a branch of the vagus nerve (CNX) that regulates the muscles of the larynx. Damage to it during surgery can cause total or partial paralysis of the vocal cords. The superior laryngeal nerve (SLN) is another branch of the CN X, which further branches into the external branch of the superior laryngeal nerve. This is divided into internal/sensory and external/motor components. The internal branch receives sensory information from the larynx above the vocal folds. The external branch innervates the cricothyroid muscle. Damage to it makes it impossible to change tone.

Damage to the CN X can cause swallowing difficulties, velum paralysis and/or voice problems with symptoms such as dysphagia, aphonia, shortness of breath, hoarseness.

A patient was referred to me with unilateral paralysis of the CVV due to damage to the appellant. The patient, a modern amateur singer, reported hoarseness, difficulty increasing the intensity, shortness of breath, diplophonia.

Recall that the myoelastic-aerodynamic theory of phonation states that the vocal folds vibrate due to air pressure and the elasticity of the vocal folds.

The patient was sent to me before starting the speech therapy rehabilitation process.

On videolaryngostroboscopy, hypomobility and glottic insufficiency related to the damage were clearly visible.

The patient was osteopathically evaluated specifically in the upper triangle for the

cranio-cervical-mandibular-laryngeal relations. The somatic dysfunctions present were noted and at the laryngeal level the classic torsion pattern was present due to non-use of some components.

The treatment attempted to "clean up the excesses" by restoring, while respecting the patient's potential, district relationships by improving organ functionality.

At the end of the osteopathic process (2 sessions) the patient reduced her symptoms and was sent to the speech therapist for the rehabilitation part of the therapy.


Valentina Carlile - Osteopath expert in Osteopathy applied to voice and speech disorders since 2002. For information and reservations visit the page Contacts

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