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Treatments and drugs
By Mayo Clinic staffTreatment of vocal cord paralysis depends on the cause, the severity of symptoms and the time from the onset of symptoms. Treatment may include voice therapy, surgery or both. In some instances, your nerve paralysis may return to normal without surgical treatment. For this reason, your doctor may delay surgery for up to a year and suggest voice therapy to keep you from using the voice improperly while the nerves heal.
Voice therapy
Voice therapy sessions involve exercises or other activities to strengthen your vocal cords, improve breath control during speech, prevent abnormal tensions in other muscles around the paralyzed vocal cord and protect your airway during swallowing.
Surgery
Surgical treatments for vocal cord paralysis can improve your ability to speak and to swallow. Surgical options include:
- Bulk injection. To add bulk to the paralyzed vocal cord, a doctor who specializes in ear, nose and throat disorders (otolaryngologist) injects your vocal cord with a substance such as body fat, collagen or another approved substance. This added bulk brings the affected vocal cord closer to the middle of your voice box so that the functioning, moving vocal cord can make closer contact with the paralyzed cord when you speak or swallow.
- Vocal cord repositioning. In this procedure, a surgeon moves a "window" of tissue from the outside of your voice box inward, pushing the paralyzed vocal cord toward the middle of your voice box so that it can better vibrate against your unimpaired vocal cord.
- Tracheotomy. If both of your vocal cords are paralyzed in a closed position, you may have trouble breathing and require a surgical procedure called a tracheotomy. In a tracheotomy, an incision is made in the front of your neck and an opening created directly into the wind pipe (trachea). A breathing tube is inserted, allowing air to bypass the immobilized vocal cords above.
Emerging treatments
Linking the vocal cords to an alternative source of electrical stimulation — perhaps a nerve from another part of the body, or a device similar to a cardiac pacemaker — may restore opening and closing of the vocal cords. Researchers continue to study this and other options.
