Neck Trauma

Call 911 for any neck injury with difficulty breathing, noisy breathing, coughing up blood, significant bleeding or swelling, or sudden weakness, numbness, or trouble speaking. These need emergency care, not an office visit.

• The voice box (larynx). Injury can change the voice or affect breathing.
• The nerves to the vocal cords. Injury to these nerves, whether from trauma or surgery in the neck or chest, can cause vocal cord paralysis: hoarseness, a weak or breathy voice, and trouble swallowing.
• The throat and swallowing. Injury can make swallowing painful or difficult, or cause food and liquid to enter the windpipe.
• The ears. Head and neck injuries can damage structures of the ear or the hearing nerve and may be associated with hearing changes or tinnitus. See Hearing & Tinnitus.

After the emergency phase, or when symptoms develop later, an evaluation is recommended for:

• A voice that stays hoarse, weak, or breathy
• Difficulty swallowing, or coughing and choking when eating or drinking
• Shortness of breath with activity or noisy breathing
• A new lump, persistent pain, or changes in sensation in the neck
• Hearing changes or ringing in the ears

The evaluation starts with a detailed history of the injury or surgery and of how symptoms have changed since. Dr. Kayem examines the neck and throat and looks directly at the voice box and vocal cords with a thin scope. Depending on the findings, imaging, a hearing test, or a swallowing evaluation may be ordered.

Treatment depends on which structures are affected. It may include voice therapy, swallowing therapy, surgical procedures to improve vocal cord position, or referral to other specialists when the injury involves structures outside the head and neck.