Vocal Cord Paralysis: Causes, Symptoms, Treatment, and More

Vocal cord paralysis occurs when one or both vocal cords are not able to move. Your vocal cords are two elastic-type bands found in your larynx (voice box), at the top of your trachea (windpipe). The damaged vocal cords remain frozen or stuck, so they do not open and close as they should.

Vocal cord paralysis can have an impact on your health as well as your daily life. This ailment can make it hard to speak, swallow, or breathe. The effect can hinder the way you express yourself to others at home, at work, and socially,

Treatment varies based on the cause of the problem. Some cases of vocal cord paralysis resolve on their own. At the other extreme, some cases need surgery to correct the problem and prevent choking.

This article describes vocal cord paralysis, its symptoms, causes, risk factors, and diagnosis. It also details treatments and outlooks for those who have it.

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The sensations caused by vocal cord paralysis vary based on the severity of your condition. It can also vary based on whether the damage involves one vocal cord (unilateral paralysis) or both vocal cords (bilateral paralysis).

Unilateral paralysis is the most common type involving the left vocal cord. Though rare, bilateral paralysis causes more severe problems and can be life-threatening.

Generally, the condition does not cause feelings of pain in your vocal cords, you will likely notice a range of different sensations that affect normal breathing:

Most cases of vocal cord paralysis occur as a result of changes related to vocal cord anatomy. They often involve abnormal functions of the primary nerves that control your voice box (the vagus nerve and its nerve branches, the recurrent laryngeal nerve, and the superior laryngeal nerve). Damage to the recurrent laryngeal nerve, which controls the vocal cord's motion, is involved in most cases of vocal cord paralysis.

These nerves help your vocal cords do the following:

In extreme cases of bilateral vocal cord paralysis, your airway becomes obstructed by frozen vocal cords because they can't completely open to allow normal breathing. It leads to aspirating (inhaling) food or liquid and life-threatening choking because your vocal cords can't completely close to protect your airway.

When you inhale food or liquid into your lungs, you increase your risk of aspiration pneumonia. This condition involves the inflammation and infection of your lungs or large airways. It is a life-threatening illness that causes choking that can lead to death.

Up to 50% of vocal cord paralysis cases are labeled as idiopathic (having no known cause). One theory says that they may occur due to nerve inflammation from the common cold virus.

When a cause is identifiable, it usually involves one of the following issues:

The type of treatment needed for your vocal cord paralysis depends on the cause of your condition, whether one or both vocal cords are involved, and how the damage affects a specific nerve.

The two treatment strategies used to treat voice cord paralysis are voice therapy and surgery.

Many cases of unilateral vocal cord paralysis are temporary problems caused by an inflamed nerve that was not cut or damaged. These cases often resolve on their own within a year without treatment. This is why permanent treatments like surgery are often delayed for at least a year after the onset of symptoms.

Voice therapy is the first treatment used while you wait for your voice to return. Similar to the process of physical therapy, voice therapy uses guided exercises to help you learn the following:

Vocal cord surgery involves treatments that can help improve your ability to speak and swallow when your vocal cord paralysis is permanent. The different techniques include the following:

Symptoms of vocal cord paralysis typically involve voice changes or discomfort. It can begin as unexplained, persistent hoarseness that lasts for more than three or four weeks. Other potential signs and symptoms include the following:

In addition to the physical changes that affect your speech, voice box paralysis can increase your risk of the following severe complications:

Breathing

The most severe complications occur from bilateral vocal cord paralysis, which can increase your risk of suffocation when the cords are paralyzed close together. This creates an obstruction that blocks the airflow into your trachea and lungs.

Aspiration

In extreme cases of bilateral vocal cord paralysis, frozen vocal cords can lead to aspiration (inhaling food or liquid into your lungs). This can increase your risk of aspiration pneumonia. This condition involves the inflammation and infection of your lungs or large airways. It is a life-threatening illness that causes choking that can lead to death.

Physococial distress

Research indicates that people who have a voice disorder as that which occurs with vocal cord paralysis have a significant prevalence of psychosocial distress. This can include the onset of the following psychological conditions in people who did not have a previous issue:

The diagnosis of vocal cord paralysis is typically made by an otolaryngologist (a physician who specializes in ear, nose, and throat disorders. Your initial consultation will involve a discussion of your symptoms and their onset to determine the cause of your problem.

The diagnosis of vocal paralysis usually involves one or more of the following procedures, depending on your symptoms:

Any adult or child can develop vocal cord paralysis. Having certain conditions can increase your risk of developing vocal cord paralysis:

Many factors determine the outlook for a case of vocal cord paralysis. The effect of voice changes and airway and swallowing problems vary based on the type of vocal cord paralysis and its severity.

Other factors, including your age, underlying conditions, and psychological perspective can impact the effect that this problem has on your physical and mental well-being.

If you depend on your voice for your career, as in professional singing, unilateral vocal cord paralysis can be devastating. However, if you use your voice for basic communication, its effect on your daily life can be minimal.

Though rare, bilateral vocal cord paralysis can require living indefinitely with a tracheotomy to maintain an open airway.

Vocal cord paralysis occurs when one or more vocal cords become frozen in place. The problem can prevent the flow of air, hinder normal speech, and leave your airway at risk of choking.

This problem results when the nerves that control your vocal cords become damaged by disease, surgery, a tumor, or a breathing tube. If the damage is minor, the problem may heal on its own without treatment. Severe cases may need surgery to correct the damaged vocal cord and move it closer to the healthy one.

The impact of vocal cord paralysis can vary based on the type of problem that occurs. Though having two damaged vocal cords is rare, it is the most severe type of this problem and needs prompt treatment.

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By Anna GiorgiAnna Zernone Giorgi is a writer who specializes in health and lifestyle topics. Her experience includes over 25 years of writing on health and wellness-related subjects for consumers and medical professionals, in addition to holding positions in healthcare communications.