Vocal cord paralysis occurs when the nerve impulses to your voice box (larynx) are disrupted. This results in paralysis of the vocal cord muscles. Vocal cord paralysis can affect your ability to speak and even breathe.
“One of the common issues that I see in my clinic is vocal cord paralysis. Patients often present with a weak, hoarse voice and possibly difficulty swallowing, depending on the severity of the paralysis,” says Jennifer P. Rodney, M.D., a fellowship-trained, board-certified otolaryngologist specializing in laryngology including voice, airway, and swallowing disorders at The Ear, Nose, Throat & Plastic Surgery Associates.
What are the Vocal Cords?
The vocal cords, also known as vocal folds, are folds of tissue in the throat that are key in creating sounds through vocalization. Represented by two bands of elastic muscle tissue, the vocal cords are located side-by-side in the voice box (larynx) just above the windpipe (trachea).
Vocal cords vibrate, modulating the flow of air that is expelled from the lungs during phonation. Controlled through the vagus nerve, the vocal folds vibrate when they are closed to obstruct the airflow through the glottis, the space between the folds. They are forced open by increased air pressure in the lungs and closed again as the air rushes past the folds, lowering the pressure. Moreover, the vocal folds stay slightly apart when you speak or sing. A person’s voice pitch is determined by the resonant frequency of the vocal folds.
Like other tissues in the body, vocal cords can be strained and damaged. Vocal cords are also subject to infections, tumors, and trauma.
What Causes Vocal Cord Paralysis?
Vocal cord paralysis is caused by damage to nerves going to the vocal cord. In essence, the nerve impulses in the larynx (voice box) are interrupted, resulting in paralysis of the vocal cord muscles. The condition can also be caused by brain damage.
“Vocal cord paralysis can be caused by many different things, including viruses, previous surgery, and sometimes it happens without knowing exactly why,” says Dr. Rodney. “However, the end result is the same in that the voice doesn’t project as much as patients would like. They may have trouble communicating in noisy environments.”
Patients with vocal paralysis typically experience:
- Vocal fatigue
- Mild to severe reduction in speech volume
- Pain in the throat when speaking
- Swallowing things down the wrong way and choking
How is Vocal Cord Paralysis Treated?
According to Dr. Rodney, patients with vocal fold paralysis can often improve the quality of their voice by engaging in voice therapy. If improvement is not satisfactory, surgery may be recommended to change the position of the affected vocal cord. Surgery can also add bulk by injecting the vocal cord with collagen, body fat, or some other substance.
“Treatment options include voice therapy with one of our speech pathologists,” she says. “It can also include a procedural option, such as a vocal cord injection or a thyroplasty. And a vocal cord injection can be performed in the office as well as in the operating room.”
Dr. Rodney decided to specialize in treating patients with voice or swallowing difficulties because she knows first hand what vocal cord problems feel like.
“I decided to pursue a fellowship in laryngology because I wanted to give patients all the options available for voice, airway, and swallowing disorders,” she says. “As a singer and a performer myself, I’ve been through some of these issues, and I have a unique perspective that I can use to help patients.”