Vocal Cord Paralysis

When we breathe in, our vocal cords open. When we breathe out, they come together to speak and form your voice. When one vocal cord is not moving well, or not moving at all, they are not able to close completely. This creates a weak and breathy voice.

Vocal cord paralysis occurs when one or both vocal folds are unable to move. This condition can affect speaking, swallowing, breathing, and overall quality of life.

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Common Symptoms

• Hoarseness
• Breathy or weak voice
• Difficulty projecting the voice
• Vocal fatigue
• Coughing while eating or drinking
• Swallowing difficulty
• Shortness of breath

Causes of Vocal Cord Paralysis

Vocal cord paralysis may occur for a variety of reasons, including:

• Surgery involving the neck, chest, thyroid, or spine
• Viral illness
• Neurologic conditions
• Trauma
• Tumors affecting the nerve that controls vocal fold movement
• Idiopathic causes, in which no specific cause is identified

Evaluation

A comprehensive evaluation may include a detailed history, examination of the voice and throat, and specialized assessment of vocal fold function including laryngeal stroboscopy. Diagnostic testing is tailored to each patient's symptoms and medical history.

Treatment Options

Treatment depends on the severity of symptoms, underlying cause, and overall vocal demands of the patient. These options can include:

• Observation and monitoring
• Voice therapy
• Injection laryngoplasty
• Medialization procedures (laryngoplasty/thyroplasty, arytenoid adduction)
• Reinnervation procedures in selected patients
• Swallowing therapy when appropriate

When to Seek Evaluation

Hoarseness lasting more than 2 weeks, unexplained voice changes, persistent hoarseness after surgery or intubation should be evaluated by a voice specialist.