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Image of Neck with Highlighted Vocal Cords

Vocal Cord Paralysis Surgery

Vocal cord paralysis happens when the nerve impulses in your voice box are disrupted. It can affect your ability to speak or breathe. This is because your vocal cords, sometimes called vocal folds, do more than just produce sound. Vocal cords also protect your airway by preventing food, drink, and saliva from entering your windpipe, which would cause you to choke.

Vocal cord paralysis can occur due to nerve damage during surgery, viral infections, stroke, neurological conditions, or certain cancers. Surgery is often called for to treat vocal cord paralysis.


Your vocal cords consist of two flexible bands of muscle tissue that are located at the entrance of the windpipe. The bands come together and vibrate to make sound when you speak. When you aren’t speaking, the vocal cords are relaxed and open, allowing you to breathe.

In most cases of paralysis, only one vocal cord is affected. Paralysis of both vocal cords is rare but serious.

Signs and Symptoms of Vocal Cord Paralysis

Signs and symptoms include:

· A breathy quality to the voice
· Hoarseness
· Noisy breathing
· Ineffective coughing
· Inability to speak loudly
· Loss of gag reflex
· Frequent throat clearing
· Loss of vocal pitch
· Choking or coughing while swallowing food, drink, or saliva
· The need to take frequent breaths while speaking

You should consult a medical professional if you have unexplained, persistent hoarseness for more than two weeks or if you notice unexplained voice changes or discomfort.

Surgical Options for Vocal Cord Paralysis

If your vocal cord symptoms do not recover naturally, surgical treatments may be offered to improve your ability to speak and swallow.

Surgical options include:

· Bulk injection — Paralysis of the nerve will likely leave the vocal cord muscle thin and weak. A doctor may inject your vocal cord with a substance such as body fat, collagen, or another approved filler substance. This will bring your affected vocal cord closer to the middle of your voice box so that the opposite functioning vocal cord can make closer contact with the paralyzed one.
· Structural implants — This procedure, known as thyroplasty, medialization laryngoplasty, or laryngeal framework surgery, uses an implant in the larynx to reposition the vocal cord.
· Vocal cord repositioning — A surgeon moves a window of your own tissue from the outside of your voice box inward, which will push the paralyzed vocal cord toward the middle of your voice box. Your functioning vocal cord can then better vibrate against its partner.
· Replacing the damaged nerve — A healthy nerve is moved from a different area of the neck to replace the damaged vocal cord. It can take as long as nine months before the voice shows signs of improvement. This surgery is sometimes combined with bulk injection.
· Tracheotomy — If both vocal cords are paralyzed and positioned close together, your airflow will decrease. In a tracheotomy, an incision at the front of your neck opens directly into the windpipe. A breathing tube is then inserted, allowing air to bypass the paralyzed vocal cords.

At Ohio Head and Neck Surgeons, we understand your concerns when seeking diagnosis and treatment options for Ear, Nose, and Throat injuries and diseases. Please contact our office to schedule a consultation with one of our quality ENT specialists. For more information on scheduling click here.

To prepare for your first appointment, you can also visit our New Patients page to find important forms you will need at your appointment including registration and health history.

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