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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, you may get better without surgical treatment. For this reason, your doctor may delay surgery for six months to a year from the beginning of your vocal cord paralysis. During this waiting period, your doctor may suggest voice therapy to help keep you from using your 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
If your vocal cord paralysis symptoms don't fully recover on their own, surgical treatments may be offered to improve your ability to speak and to swallow. Surgical options include:
- Bulk injection. Paralysis of the nerve to your vocal cord will probably leave the vocal cord muscle thin and weak. To add bulk to a paralyzed vocal cord, a doctor who specializes in ear, nose and throat disorders (otolaryngologist) may inject your vocal cord with a substance such as body fat, collagen or another approved filler substance. This added bulk brings the affected vocal cord closer to the middle of your voice box so that the opposite functioning and moving vocal cord can make closer contact with the paralyzed cord when you speak, swallow or cough.
- Vocal cord repositioning. In this procedure, a surgeon moves a window of your own tissue from the outside of your voice box inward, pushing the paralyzed vocal cord toward the middle of your voice box. This allows your unimpaired vocal cord to better vibrate against its paralyzed partner.
- Tracheotomy. If both of your vocal cords are paralyzed and positioned closely together, your airflow will be decreased. In this situation, you'll have a lot of 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.
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.
- Vocal cord paralysis. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/vocalparal.htm. Accessed Jan. 22, 2010.
- Vocal cord paralysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec08/ch092/ch092g.html. Accessed Jan. 22, 2010.
- Fact sheet: Vocal cord paralysis. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/vocalChordParalysis.cfm. Accessed Jan. 24, 2010.
- Wareing M, et al. Vocal cord paralysis. In: Lalwani AK. Current Diagnosis and Treatment in Otolaryngology — Head & Neck Surgery. 2nd ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2827843. Accessed Jan. 21, 2010.
- Lustig LR, et al. Ear, nose, and throat disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2010. 49th ed. New York, N.Y.: McGraw-Hill Medical; 2009. http://www.accessmedicine.com/content.aspx?aID=2356. Accessed Jan. 21, 2010.
- Deckert J, et al. Vocal cord dysfunction. American Family Physician. 2010;81:156.
- Rubin RT, et al. Vocal fold paresis and paralysis. Otolaryngologic Clinics of North America. 2007;40:1109.
- Maragos NE (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 26, 2010.
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