Vocal cord paralysis most commonly occurs due to damage of which nerve?

Vocal cord paralysis is most commonly attributed to damage of the recurrent laryngeal nerve. This nerve is a branch of the vagus nerve and is crucial for the motor control of most of the intrinsic muscles of the larynx, which are responsible for vocal cord movement. When the recurrent laryngeal nerve is injured, it can lead to an inability to abduct or adduct the vocal cords effectively, resulting in conditions such as hoarseness, breathy voice, or even airway obstruction in severe cases.

The recurrent laryngeal nerve has a unique anatomical course, looping under the aortic arch on the left side and around the subclavian artery on the right, making it susceptible to various forms of injury, including surgical trauma during neck or thoracic procedures, compression tumors, or even viral infections. Damage to this nerve therefore presents a clear clinical picture of vocal cord paralysis due to its direct role in laryngeal function.

Other nerves mentioned, such as the glossopharyngeal, hypoglossal, and superior laryngeal nerves, while essential to other functions in the head and neck, do not primarily control the vocal cord muscles involved in phonation to the same extent as the recurrent larynge