Diseases of the throat and nasal passages; a guide to the diagnosis and treatment of affections of the pharynx, sophagus, trachea, larynx, and nares . Fig. 185.—Bilateral paralysis of thyroarytenoidsin acute laryngitis (Ziemssen). Fig. 1S6.—Unilateral paralysis of (right) thyroarytenoid (Ziemssen). and vocal effort is fatiguing or even painful. If associatedwith paralysis of other muscles in the domain of the inferiorlaryngeal nerve, there is dysphonia or aphonia, as the case maybe.. MOTOR PARALYSES OF THE LARYNX. 641 Diagnosis.—The vocal cords approximate posteriorly, butnot without a decided
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Diseases of the throat and nasal passages; a guide to the diagnosis and treatment of affections of the pharynx, sophagus, trachea, larynx, and nares . Fig. 185.—Bilateral paralysis of thyroarytenoidsin acute laryngitis (Ziemssen). Fig. 1S6.—Unilateral paralysis of (right) thyroarytenoid (Ziemssen). and vocal effort is fatiguing or even painful. If associatedwith paralysis of other muscles in the domain of the inferiorlaryngeal nerve, there is dysphonia or aphonia, as the case maybe.. MOTOR PARALYSES OF THE LARYNX. 641 Diagnosis.—The vocal cords approximate posteriorly, butnot without a decided bulging outward at the central portionof the glottis, the orifice of whichduring phonation is elliptic (Fig. 185).In unilateral paralysis, the ellipse isincomplete (Fig. 186). When asso-ciated with paralysis of the arytenoidmuscle, the ellipse is incomplete pos-teriorly at the vocal processes of thearytenoid cartilages, and the inter- J^S^^STTS^Skcartilaginous portion of the rima glot- (Ziemssen)-tidis bulges outward (Fig. 187), from failure of contact of thecartilages and their processes. Prognosis.—Satisfactory restoration of voice may be ex-pected in cases resulting from simple over-exertion of the voice, and in those occurring in acute laryngitis. In cases due toover-use of the voice, during the period of normal change, it ismore doubtful. The singing voice is sometimes impaired per-manently. Treatment.—This consists in resting the voice, and in sys-tematic vocal ex