Vocal Cord Paralysis

The Voice Center at UT Southwestern Medical Center offers exceptional expertise in diagnosing and treating vocal cord paralysis and other voice disorders. Our multidisciplinary team includes fellowship-trained laryngologists and speech-language pathologists who are committed to improving voice quality.

Advanced Care for Vocal Cord Paralysis

The vocal cords are located in the larynx (voice box) and vibrate to produce sound for speaking and singing. Vocal cord paralysis occurs when one or both vocal cords lose the ability to move, which can affect the voice, breathing, and swallowing.

Our multidisciplinary team combines the expertise of fellowship-trained laryngologists (ear, nose, and throat specialists with specialized training in disorders of the larynx), speech-language pathologists with training specifically in voice care, and other care professionals with expertise in voice and throat conditions. Our team members are widely recognized as experts in the accurate diagnosis and effective treatment of vocal cord paralysis. Through our research, we have made important contributions to the standard of care and are improving the lives of patients, here and across the country.

Causes of Vocal Cord Paralysis

Vocal cord paralysis develops when nerves that control the vocal cord muscles become damaged or inflamed. Often, the underlying causes of vocal cord paralysis are not known. Some known causes include:

• Viral infections
• Injuries to the neck or chest
• Injury to the vocal cord nerve during surgery in nearby areas
• Neurological disorders such as multiple sclerosis
• Noncancerous tumors
• Stroke
• Vocal cord cancer
• Cancer in the chest or neck

Symptoms of Vocal Cord Paralysis

Symptoms include:

• Breathy or weak-sounding voice
• Changes in vocal pitch (high or low)
• Choking or coughing while swallowing
• Difficulty breathing
• Difficulty swallowing
• Hoarseness
• Inability to speak loudly
• Noisy breathing

Diagnosis of Vocal Cord Paralysis

Our voice care team at UT Southwestern includes fellowship-trained laryngologists and speech-language pathologists who conduct a thorough evaluation, which can include:

• Physical exam, with an inspection of the vocal cords
• Review of personal medical history
• Discussion of symptoms

Other tests we typically use include:

• Laryngoscopy: An exam using a narrow tube, either flexible or rigid, with a light and camera inserted through the nose
• Videostroboscopy: An exam using a telescope-like camera with a flashing light that provides a magnified, slow-motion view of the vocal cords as they vibrate
• Laryngeal electromyography (EMG): Small needles inserted through the skin into voice box muscles to measure their electric currents
• Sound (acoustic) analysis: Computer analysis that identifies abnormalities in the sounds produced by the vocal cords

Treatment for Vocal Cord Paralysis

At UT Southwestern, we usually begin treatment for vocal cord paralysis with nonsurgical therapies, such as:

• Speech therapy, with exercises to strengthen vocal cords, improve breath control during speech, and protect the airway when swallowing
• In-office filler injections to enlarge a paralyzed vocal cord so that it comes in contact with the functioning cord to produce sound, for improved voice quality and a more efficient cough

We typically recommend surgical procedures for patients whose symptoms don’t improve with conservative treatments. Our surgeons offer:

• Injection augmentation to the paralyzed vocal cord using fat typically taken from the belly
• Thyroplasty: Surgery to place an implant in the paralyzed vocal cord and position it closer to the functioning vocal cord
• Arytenoid adduction: Surgery to position the paralyzed vocal cord joint closer to the functioning vocal cord to improve speech, breathing, and swallowing
• Laryngeal reinnervation surgery: Procedure to connect a damaged nerve to a functioning nerve to improve nerve signals that control vocal cord muscles