Vocal Cord Paralysis

Voice And Throat

Vocal cord, or vocal fold, paralysis occurs when one or both of the two vocal cords lose the ability to move. Movement of the vocal cords is responsible for producing voice, coughing, and even protecting the airway from inhaling food or drink during swallowing. At rest and during breathing, the left and right vocal cords appear as an inverted V, and during speech the cords move towards each other until they come into contact, vibrating as the air passes through. When an injury to the laryngeal nerve causes paralysis of one or both vocal cords, they can no longer move into contact with each other, causing hoarseness or even complete loss of voice.

voice paralysis


Adults suffering from vocal cord paralysis use a lot of effort when trying to speak. They have weak, breathy voices, and experience coughing and choking while eating or drinking. Recurrent pneumonia may occur in some individuals.


There are a variety of causes for vocal cord paralysis including inadvertent injury during neck or chest surgery, complication from endotracheal intubation, neck or chest trauma, tumors of the skull base, neck, and chest, viral infections, or other central nervous system diseases. A large percentage of cases are idiopathic (of unknown cause).

Treatment Options

There are several treatment options for vocal cord paralysis. The preferred option depends on each patient’s individual condition.

  1. Voice therapy is often the first recommended treatment protocol. This therapy utilizes exercises to strengthen a patient’s vocal cords, improve breath control during speech, or protect the airway during swallowing.
  2. Medializinginjections of body fat, dermal fillers, collagen or other approved substances are injected into spaces next to the vocal cords.These are used to push the affected vocal cord closer to the middle of the voice box so that the functioning, moving vocal cord can make closer contact with the paralyzed cord when a patient speaks or swallows.
  3. Medialization thyroplasty is an outpatient procedure which utilizes an implant device to push the paralyzed vocal cord toward the middle of the voice box. Implants made of Gortex, silicone, or other materials are positioned into the same spaces that are used for medialization injections, but because the implants are not biodegradable, the results can be permanent.
  4. A tracheotomy may be needed if the patient has trouble breathing due to bilateral (both left and right) vocal cord paralysis and the vocal cords are in a closed position.

The physicians at CornerStone Ear, Nose & Throat are experts at diagnosing and treating vocal cord paralysis and other voice problems. We can perform endoscopic injections to restore voice without the need for any incisions, avoiding the associated pain, scars, and recovery time. Not all cases of vocal cord paralysis will respond to this method however. Our surgeons are experienced with the full range of voice restoration surgeries for these cases.

Patients experiencing prolonged hoarseness should consult one of the board-certified otolaryngologists at CornerStone Ear, Nose and Throat, PA. While these symptoms could indicate a vocal cord paralysis, there are a variety of other conditions that could be the cause. The physicians at CornerStone Ear, Nose & Throat, PA, will gladly help you understand and resolve your voice difficulties.

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