Google CEO Articulates His Diagnosis of Vocal Cord Paralysis

Last week was one of celebrities disclosing their medical histories. First, it was Angelina Jolie writing in a New York Times op-ed that she had a undergone a double mastectomy to prevent breast cancer given a strong family history. The following day, it was Google co-founder Larry Page who posted an entry on his company’s social network Google+ that he had the diagnosis of vocal cord paralysis (also called “paresis”).


Page began by writing that nearly a decade and a half ago, he suffered a viral upper respiratory infection (URI). While the accompanying voice hoarseness was not unique–millions would attest to having this symptoms every cold season–Page’s voice didn’t fully recover. Work-up revealed his left vocal cord to be paralyzed. Of note, the left cord is the one paralyzed in two of three patients with vocal cord paralysis. While inconclusive, the presumptive cause was “virus-based damage from my cold,” wrote Page.


Fourteen years later, last summer, another serious URI afflicted Page. The previously normal right vocal cord became paralyzed leaving him with what he labeled an “extremely rare” condition. Indeed, in the majority of vocal cord paralysis cases, only one of the two cords is affected and having back-to-back episodes


Common symptoms of vocal cord paralysis include hoarseness, “breathy” voice, difficulty modulating vocal pitch and increasing amplitude, and frequent throat clearing.


Public speaking is often near impossible when suffering from vocal cord paralysis. Therefore, it’s little surprise that Page was forced to cancel several public appearances last summer. Patients may also have breathing complications (especially in bilateral cases) and are at a high risk for aspiration as the vocal cords function as barriers preventing food and fluids from entering the trachea.


Other than the suspected URI in Page’s condition, causes include injuries resulting from otolaryngeal surgeries or neck trauma, neoplasms on the voicebox apparatus and surrounding tissues, multiple sclerosis, or Parkinson’s disease. About 1 in 3 cases remain idiopathic.


The work-up includes a laryngoscopy to rule out tumors. Page didn’t go into details but this procedure along with imaging were surely part of the “thorough examination” he underwent to try to identify a cause. Treatments consist of new surgical interventions and voice therapy. As Jolie hoped that her announcement would guide “many women who do not know that they might be living under the shadow of cancer” to get tested for the BRCA gene, Page used his post to announce that he and his wife were going to finance “a significant research program” under the direction of the voice expert Dr. Steven Zeitels, whose patient panel includes the ranks of Adele, Aerosmith’s Steven Tyler, and Julie Andrews.

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