Vocal cord paralysis describes the immobility of one of the vocal folds. The vocal folds are designed to work as a pair, with both cords opening or closing at the same time like a valve. When one vocal fold is not working, it may result in a change in voice quality and difficulty swallowing due to leakage through the valve. When both vocal folds are not working, patients often report a near normal voice with difficulty breathing or a poor, breathy vocal quality with essentially normal breathing.

The function of the vocal folds can be impacted by injury to the recurrent laryngeal nerve that controls the voicebox. The injury may be due to the presence of a tumor, a stroke, or a prior history of surgery involving the neck or chest. In some cases, there is no clear reason why the nerve is no longer working, and that phenomenon is called “idiopathic vocal fold paralysis.”

The diagnosis is made by taking a complete history and carefully examining the vocal cords either by flexible laryngoscopy (a flexible camera placed through the nose) or a videostroboscopy (a flexible or rigid exam of the vocal cords which allows for examination of the vocal fold mucosal wave). Further workup may include electrical studies or imaging studies, such as a CT or MRI scan of the neck and chest, to ensure there are no masses along the length of the entire nerve. Depending on the position of the immobile vocal fold, initial therapy may involve speech therapy to optimize the function of the voice. Other management strategies include the use of an office-based temporary injection to move the vocal fold into a better position that results in better function of the valve. Permanent treatment options include a surgery to place an implant in the voicebox to maintain the position of the vocal fold at all times.

The information contained on this website is intended for educational purposes only and is not intended to diagnose and/or dictate treatment for any disease process. Please consult your physician for management tailored to your specific condition.