What nerves are damaged when choking on water?

When we drink water, it seems like a small thing, but in fact it may mean serious consequences. When drinking water, we may choke and cough due to the introduction of air or distraction of our mind, and our nerves may be damaged to a certain extent at this time. So what causes this problem? Is there any good way to solve this problem?

1. Causes

After the recurrent laryngeal nerve branches off from the vagus nerve, it runs on the left and right sides in the tracheoesophageal groove. Slight traction or direct contact can cause paralysis. Direct mechanical operations such as clamping, excessive traction, suturing or even cutting during surgery, as well as indirect causes such as postoperative wound edema, hematoma compression or scar compression may cause recurrent laryngeal nerve injury.

2. Clinical manifestations

The recurrent laryngeal nerve on both sides is divided into anterior and posterior branches. The anterior branch innervates the adductor muscles of the vocal cords, and the posterior branch innervates the abductor muscles of the vocal cords. The main manifestations of recurrent laryngeal nerve injury are as follows.

1. Hoarseness

It is the main symptom of recurrent laryngeal nerve injury. Unilateral injury to the entire branch or anterior branch of the recurrent laryngeal nerve often causes hoarseness, which can seriously affect the patient's work and life, especially for patients working in professions such as teachers and actors. Unilateral injury to the posterior branch of the recurrent laryngeal nerve may not cause obvious symptoms in terms of breathing and pronunciation.

2. Loss of voice

Injury to the entire branch and anterior branch of the bilateral recurrent laryngeal nerve often causes aphonia.

3. Coughing while drinking water

It is often accompanied by hoarseness and is a common symptom of recurrent laryngeal nerve injury. The pathogenesis is mainly caused by incomplete closure of the glottis during swallowing, resulting in liquid leakage into the trachea.

4. Difficulty breathing or choking

The posterior branches of the bilateral recurrent laryngeal nerves are damaged, and the patient's ventilation function is severely impaired, which may cause breathing difficulties or even suffocation.

5. other

Temporary paralysis of the recurrent laryngeal nerve is mostly caused by edema, hematoma or scar compression, and usually recovers on its own within 3 to 6 months. Those with very minor injuries can recover within 1 to 2 weeks after surgery. Patients with permanent damage to the recurrent laryngeal nerve on one side often recover gradually through compensation by the contralateral recurrent laryngeal nerve.

3. Inspection

Laryngoscopy is the main basis for diagnosing recurrent laryngeal nerve injury.

4. Diagnosis

1. Medical history includes history of thyroid surgery.

2. Clinical manifestation: hoarseness. Some patients develop hoarseness after waking up from anesthesia, and laryngoscopy can reveal paralysis of one side of the vocal cord.

5. Differential Diagnosis

Recurrent laryngeal nerve injury should be differentiated from two other disorders that present with hoarseness: vocal cord edema and cricoarytenoid dislocation. Among them, the voice of vocal cord edema can be restored after correct treatment, and the voice of cricoarytenoid joint dislocation can also be restored after joint reduction.