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Understanding Vocal Cord Paralysis - The Voice Disorder that Leaves You Silenced

Updated: Apr 8

The rate of occurrence of vocal cord paralysis is about 0.42%, with the male-to-female ratio being 3:1.  

Proper communication and voicing opinions are part and parcel of healthy living. They are our basic rights that help make life’s journey easy. But what happens when you are robbed of this freedom of speech? And not by any powerful external organization, but by your own body. Sounds frustrating, right? Well, that is the kind of emotion a victim of vocal cord paralysis feels every single time they wish to express.  

Understanding Vocal Cord Paralysis - The Voice Disorder that Leaves You Silenced

Vocal cords choreograph the melodies of speech with flawless precision. But nerve damage often leads to restrictions on their movement. Resulting in difficulty speaking, gulping down, or even breathing. All of which can affect daily life to a significant extent.

So, here’s a detailed guide on vocal cord paralysis. From causes and symptoms to potential treatment that might prove helpful for you.

What is Vocal Cord Paralysis?

Vocal cords, or folds, are the muscles in the vocal box known as the larynx, based on the top of the trachea (windpipe). They open, close, and touch when you breathe, eat/ drink, and speak, respectively. With vocal cord paralysis, nerve damage makes them weak or immobile. In other words, you fail to control the motion of these muscles that otherwise control your voice. The situation can be both temporary and permanent, depending on the extent of the damage. 

Also known as vocal fold paralysis, the condition can be classified into two types.

  1. Unilateral vocal cord paralysis - In this only one of the vocal cords is paralyzed. This leads to swallowing or speaking complications. But breathing problems are usually not a concern here. 

  2. Bilateral vocal cord paralysis - This affects both the vocal folds. The cords get very close to one another and create an extremely narrow airway. The result can not only lead to breathing issues but may also become fatal without a proper cure. 

Unilateral vocal cord paralysis is the more common of the two types. 

Vocal Cord Paralysis Symptoms

The kind of symptoms you get depends on how much your cords have paralyzed. Some victims may face mild issues while others go through a life-death situation. The vocal cord paralysis position also determines the severity of the disorder. 

Look for the following symptoms to identify the condition quickly:

  • Scratchy or hoarse voice

  • Changes or loss of vocal pitch

  • Changes in vocal volume

  • Noisy breathing or wheezing

  • Inability to speak loudly

  • Shortness of breath

  • Coughing or choking while gulping food, drinks, or saliva

  • Difficulty clearing throat

How Does Vocal Cord Paralysis Happen? - Causes

Numerous variables can impact the nerve impulses in your larynx. Leading to the diverse vocal cord paralysis symptoms. 

Some of the more well-known causes include:

  • Injury to the vocal folds during surgery. 

  • Nerve damage from neck or chest injury.

  • Stroke

  • Infections leading to inflammation or damage to the voice box nerves.

  • Neurological conditions involving nerve deterioration (Parkinson's disease/ multiple sclerosis).

  • Autoimmune disorders that interfere with nerve communication.

  • Exposure to toxic and harmful substances like lead and mercury.

  • Tumors (both malignant and benign tumors can damage the nerves).

Vocal Cord Paralysis Diagnosis

Otolaryngologists (ear, nose, and throat doctors) are specialists in diagnosing vocal cord paralysis. They usually start by asking about the symptoms and your overall health history. After that, you may be recommended a few more tests to confirm vocal cord paralysis diagnosis. 

  1. Imaging studies - MRI or CT scans help detect growths that may cause nerve damage in the voice box.

  2. Laryngoscopy - In this, the provider uses a flexible tube called a laryngoscope. It has a camera that when inserted through your nose captures pictures of your voice box and vocal folds. 

  3. Videostroboscopy - This is quite similar to Laryngoscopy. It helps monitor the movement of the cords when you are speaking. 

  4. Laryngeal electromyography -  LEMG determines how your nerves control the voice box muscles.

  5. Blood test- Doctors suggest blood tests if they suspect infection to have caused vocal cord paralysis in your case. The same rule applies to autoimmune diseases as well. 

Vocal Cord Paralysis Treatment

Due to the evolution of medicine, we today have varied methods to treat vocal cord paralysis. But the kind of cure you need will depend on: 

  • Vocal cord paralysis causes

  • The severity of the case

  • The time of the onset of the vocal cord paralysis signs

Here are the best vocal cord paralysis remedies that have shown maximum results. Please note that at times, a combination of treatments works best for a full cure.

  1. Vocal cord paralysis therapy

Voice therapy for vocal cord paralysis is a very effective option to treat the disorder. It is usually suggested when the position of the cords does not need repositioning. Instead, you need to take sessions that include exercises and activities that:

  • Make your vocal cords strong

  • Improve the way you control your breath while talking

  • Prevent tension within the surrounding muscles

  • Safeguard your airways while you swallow

  1. Vocal cord paralysis surgery

Doctors recommend vocal cord paralysis surgery when your signs do not get better on their own. In many cases, they wait for a few months to a year before giving it a go. The surgical choices include:

  • Bulk injection - Body fat, collagen, or filler substances are injected to add bulk to the cords. 

  • Structural implants - An implant is done to reposition the vocal fold. 

  • Vocal cord repositioning - This cure involves pushing the cord toward the center of the voice box. Thereby helping it to vibrate better. 

  • Damaged nerve replacement- A nerve is relocated to replace the paralyzed cord. Post this surgery, the patient takes at least 6-9 months to get their voice back. 

  • Tracheotomy - This is suggested when the vocal cord paralysis position is very close. Here, the physician inserts a breathing tube to allow air to pass through.

Final Thoughts - Can Vocal Cord Paralysis be Reversed?

Many victims of vocal cord paralysis see their symptoms disappear with time. Others find the filler injections and vocal cord paralysis therapy of great help. Sadly, a few are unlucky enough to find their vocal cords permanently paralyzed. In that situation, an implant is the best option. 

With a suitable vocal cord paralysis treatment, it is possible to talk and swallow again. The actual prognosis depends on the individual health situation.

Whether yours is unilateral or bilateral vocal cord paralysis, mild or extreme, talk to a specialist as soon as you notice signs. Then get started with the treatment to prevent the worsening of the condition. 

I hope this gives you some hope about the peculiar condition.


The Author : Dr. Sunil Khattri 

+91 9811618704

Dr. Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.

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