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Vocal Cord Immobility (Vocal Cord Paralysis)

The vocal cords open up when we breathe to allow air to pass into the windpipe. They close (and vibrate) when we talk, swallow and cough. When one vocal cord does not move properly (unilateral vocal cord immobility), it can lead to a weak, breathy voice, inability to raise the volume of the voice, and the sensation of running out of air while speaking. Problems with swallowing and a weak cough are common as well. When both vocal cords do not move properly (bilateral vocal cord immobility), patients may experience trouble breathing.

Vocal Cord Immobility: What You Need to Know

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  • There are many reasons why a vocal cord may not move properly, but it is most often related to a problem with the nerve that controls the muscles that move the vocal cord and not a problem with the actual vocal cord itself. Injury to the nerve following surgery in the neck or chest is a common cause of vocal cord immobility.
  • Other causes of vocal cord immobility include stroke, neurologic disorders, tumors in the voice box, neck, thyroid or chest that cause the vocal cord nerve to malfunction, neck trauma, and voice box trauma after having a breathing tube in your windpipe.
  • The goal of treatment for unilateral vocal cord immobility is to move the impaired vocal cord over to the middle to close the gap between the two vocal cords during talking, swallowing and coughing.
  • The goal of treatment for bilateral vocal cord immobility is often aimed at securing a safe way for a patient to breathe. This may involve placement of a breathing tube in the neck (tracheotomy) or making a small cut in the back of the vocal cord(s) to open up the airway for breathing.

Patient Resources

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Why Choose Johns Hopkins for Vocal Cord Immobility?

Johns Hopkins Voice Center Doctors

Our Physicians

Rely on the expertise of our physicians to treat vocal cord immobility.



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Our Patient Education

Dr. Lee Akst, Director of the Johns Hopkins Voice Center, answers some of the most frequently asked questions.

Watch our Voice Center FAQ video.