Vocal Cord Paralysis

Created in Throat

People have one set of two vocal cords, also known as vocal folds, that work together in your voice box to produce sound. They open when you breathe in to let the air flow through your lungs, and they close and vibrate when you speak (this is called phonation). To produce adequate voice, both vocal cords should move toward each other and close completely to vibrate together (this is called glottic closure).

Your vocal cords move through the contraction of various muscles controlled by your brain and a specific set of nerves. Vocal cord paralysis and paresis can result from abnormal function of the nerves that control your voice box muscles (laryngeal muscles). Paralysis is a complete absence of vocal cord movement, caused by a complete loss of nerve input; paresis is a weakened vocal cord movement, caused by a partial loss of nerve input. There are two nerves that can be involved:

Depending on your needs, vocal cord paralysis can cause great difficulty or only mild problems. For instance, if you’re a professional singer, even mild paresis might end your career; if you’re a computer programmer, however, you might see little ill effect.

What Are the Symptoms of Vocal Cord Paralysis?

Symptoms of paralysis and paresis of the vocal cords can include:

These symptoms can be mild to severe depending on the degree of paralysis, and the ability of your voice box to adapt. Depending on the cause, your symptoms may resolve with time or persist.

What Causes Vocal Cord Paralysis?

Vocal cord paralysis can happen at any age and come from different causes, including:

How is Vocal Cord Paralysis Diagnosed?

If you suffer from symptoms of vocal cord paralysis, you should see an ENT (ear, nose, and throat) specialist, or otolaryngologist, who may diagnose your condition from one or more of these methods:

What Are the Treatment Options?

Depending on the severity of your vocal cord paralysis and how much it affects your everyday life, your ENT specialist can offer different treatments options, including:

Voice therapy—Like physical therapy for an injured knee, voice therapy can help improve vocal function before having to consider surgery.

Surgery—The decision to have surgery depends on the degree of the symptoms, voice needs, position of the problem vocal cord, the outlook for recovery, and the cause of the problem, if known. There are two main types of surgical procedures to treat vocal cord paralysis:

If you suffer from vocal cord paralysis, your doctor will be able to guide you and find the best treatment options for your symptoms and needs.

What Questions Should I Ask My Doctor?

  1. What is the cause of my vocal cord paralysis?
  2. Is my vocal cord completely paralyzed or only partially paralyzed?
  3. Does vocal cord paralysis affect my ability to swallow properly?
  4. What are the chances of recovery if I don’t pursue any treatment?
  5. What are the chances of complications (e.g., aspiration pneumonia or swallowing problems) if I don’t pursue any treatment?

Copyright 2021. American Academy of Otolaryngology–Head and Neck Surgery Foundation.

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