Vocal Fold Paralysis

What Is Vocal Fold Paralysis?

Your vocal folds are inside your larynx, or voice box. When you talk, air moves from your lungs through the vocal folds to your mouth. The vocal folds vibrate to produce sound. Anything that makes it harder for the vocal folds to vibrate can cause a voice problem. In vocal fold paralysis, one or both vocal folds cannot move. It can also cause breathing and swallowing problems.

There are different types of vocal fold paralysis:

• Unilateral vocal fold paralysis—One vocal fold does not move. It is more common than bilateral paralysis.
• Bilateral vocal fold paralysis—Both vocal folds are not moving correctly, which can affect your airway. In some cases, people will need a tracheostomy (a surgically opened hole in the neck) to open the airway and help with breathing.

What Are Signs of Vocal Fold Paralysis?

Vocal fold paralysis can cause mild or severe problems when talking. Some signs include:

• Being unable to speak loudly.
• Being able to produce voice for a very short time.
• Hoarseness.
• Breathy voice.
• Limited pitch and loudness.
• Choking or coughing while eating.
• Possible pneumonia if food and liquid get into the lungs. This may happen if the vocal folds cannot close to protect the airway while swallowing.

What Causes of Vocal Fold Paralysis?

Nerve damage causes vocal fold paralysis. The vagus nerve runs from the brainstem to the larynx. This nerve controls vocal fold movement. Anything that damages this nerve can cause paralysis, including head and neck injuries, tumors, disease, surgery, or stroke.

What Does Testing for Vocal Fold Paralysis Look Like?

You should see your doctor if you have trouble with your voice. You may want to see an otolaryngologist, or ear, nose, and throat doctor, who knows about voice problems. An SLP can test how your voice sounds. The SLP or doctor can look at your vocal folds through a tube that goes into your mouth or nose, called an endoscope. A flashing light, called a stroboscope, allows SLPs and otolaryngologists watch your vocal folds move.

What Does Treatment for Vocal Fold Paralysis Look Like

Bilateral paralysis requires medical treatment. You may need to have a tracheotomy so you can breathe and eat safely. You might have surgery to bring one or both vocal folds closer to the middle.

You may need medical treatment for unilateral paralysis. Treatment might include muscle-nerve transplant or surgery to move the paralyzed fold toward the middle of your throat. You might also have something injected into the fold to make it larger. This procedure allows the other fold to move closer to it and may help your voice.

Voice therapy can also help unilateral paralysis. You can work with an SLP who specializes in voice to change your pitch and to get more breath support to speak louder. Changing your head position or pushing on your larynx may help your voice. Your doctor may want you to try voice therapy before surgery or other medical treatments. It may be the only treatment that you need.

To find an SLP or audiologist near you visit ProFind.

Other Resources

Inclusion on this list does not imply endorsement.

• Academy of Otolaryngology–Head and Neck Cancer Vocal Cord Paralysis information
• View  video examples of vocal cord paralysis