Vocal Cord Paralysis

What is Vocal Cord Paralysis

Vocal cord paralysis is the inability of one or both of your vocal cords to move properly because the muscles are paralyzed. The vocal cords are two elastic muscles located inside the voice box (larynx). When you breathe in (inhale), your vocal cords open wide to let air pass into your lungs. When you eat or swallow, your vocal cords close tightly to keep food or liquids from passing into your lungs. When you speak, your vocal cords come close together and vibrate to create sound.

In most cases, vocal cord paralysis affects only one vocal cord (unilateral). Rarely, both vocal cords are affected (bilateral).

What are the causes?

This condition may be caused by:

• Damage to a nerve that controls vocal cord movement.
• Neck or chest injury.
• Cancer of the larynx, neck, brain, or chest.
• Stroke.
• Nervous system diseases.
• Viral infections.

Sometimes the cause is not known (idiopathic).

What are the signs or symptoms?

Symptoms of this condition depend on whether one or both vocal cords are affected and where they are affected. Signs and symptoms include:

• Voice changes, such as:
  • The inability to speak loudly.
  • Having limited variety of high and low sounds (pitch).
  • Having limited variety in loudness.
  • A voice that lasts for a short time (about 1 second).
• Trouble breathing.
• Hoarseness.
• Weak, breathy voice.
• Noisy breathing.
• Choking and coughing while eating or drinking (aspiration). This can lead to a lung infection (pneumonia).

How is this diagnosed?

This condition may be diagnosed based on:

• Medical history.
• A physical exam.
• Other tests to confirm the diagnosis, such as:
  • An exam of your vocal cords with a lighted, flexible scope (endoscopic laryngoscopy).
  • An exam that measures the electrical currents in the nerves and muscles of your larynx (laryngeal electromyogram).
  • Blood tests.
  • X-rays.
  • Imaging studies, such as an MRI or CT scan.

How is this treated?

Treatment for this condition depends on the type of paralysis you have. Treatment may include:

• Speech therapy.
• Injecting a paralyzed vocal cord with a substance to increase its size.
• Surgery to move one cord close to the other.
• Muscle and nerve transplants.

Follow these instructions at home:

• Eat and drink slowly.
• Avoid very hot or very cold food or drinks.
• Rest your voice. Avoid speaking too much, too long, or too loudly. Do not whisper.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. This includes any speech therapy visits.

Contact a health care provider if:

• Your voice is weaker or more hoarse.
• Your breathing is getting noisy.
• You cough or choke while eating or swallowing.
• You have a cough and a fever.

Get help right away if:

• You have trouble breathing.
• You have chest pain.

Summary

• Vocal cord paralysis is the inability of one or both of your vocal cords to move properly because the muscles are paralyzed.
• Common symptoms include changes in your voice, trouble breathing, hoarseness, noisy breathing, and choking and coughing while eating or drinking.
• Paralysis is diagnosed by medical history, physical exam, blood tests, an exam of the vocal cords (laryngoscopy), MRI, and other tests.
• Treatment includes speech therapy, injections, surgery, and muscle or nerve implants.