Paralysis of the vocal cords may occur when one or both vocal cords do not open or close properly – most cases are unilateral (only involving one side). While the most common cause of vocal cord paralysis is surgical injury, other causes include:

Image of a paralyzed vocal cord being
treated by injection in the office

• Stroke
• Neck trauma
• Viral infection
• Tumors which sit along the nerves to the voice box

Sometimes the cause for vocal cord paralysis is never identified, and the paralysis is termed idiopathic.

Symptoms of vocal cord paralysis include:

• Weak, breathy voice
• Running out of air while speaking
• Inability to get loud
• Vocal strain
• Coughing and/or choking during swallowing (more likely with thin liquids)

Diagnosing Vocal Cord Paralysis

Vocal cord paralysis is typically diagnosed by stroboscopy – a camera and pulsing light are used to visualize vocal cord function, which reveals the limited vocal cord motion.

Vocal Cord Paralysis Treatment

The goal of treatment for unilateral vocal cord paralysis is to move the paralyzed vocal cord over to the middle to close the gap between the two vocal folds during speech. This procedure to move the vocal cord over is called “medialization”, and there are different ways to re-position the paralyzed vocal cord.

The choice of treatment depends upon the cause of the paralysis and the possibility for nerve recovery. Vocal cord paralysis treatment options include:

• Temporary injections, which typically last one and a half to two and a half months.
• Long-term injections, which typically last one and a half to two years.
• Permanent implants, which are placed into the voicebox through an external incision into the neck.

Make an Appointment

Contact the Johns Hopkins Voice Center by calling 443-997-6467 (443-997-OHNS).