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true vocal fold
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A paralyzed vocal fold is flaccid and in an intermediate (cadaveric) position. Symptoms include:
1. breathy, hoarse voice
2. weak cough
3. risk of aspirating fluids
4. exertional dyspnea
Both vagus nerve and RLN (recurrent laryngeal nerve) injuries result in the same appearance of the vocal folds (intermediate position). After injury, axons of the RLN are capable of regeneration the affected vocal fold adducts (moves medially) because the regenerated RLN innervates different muscles than prior to the injury and there are more adductor motor units than abductor units (the latter is represented only by the posterior cricoarytenoid muscle). Note that a damaged RLN does not always regenerate and that bilateral RLN injury eventually would lead to an unacceptable narrowing of the glottis.
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