Vocal cord paralysis is a health condition that affects the two folds of tissue in your voice box called the vocal cords. These folds are important for your ability to speak, breathe, and swallow.

One or both of your vocal cords can be affected by vocal cord paralysis. This condition requires medical attention and often requires surgery to restore communication between the nerves in your vocal cords and your brain.

Vocal cord paralysis symptoms will vary by the cause and whether one of both of your vocal cords are affected. You may experience one or more of the following:

  • hoarseness or complete loss of speaking ability
  • difficulty swallowing
  • breathing difficulty
  • inability to raise your voice in volume
  • changes in the sound of your voice
  • frequent choking while eating or drinking
  • noisy breathing

If you notice those symptoms or you detect any significant changes in your speech pattern and the quality of your voice, contact an ear, nose, and throat doctor for an evaluation.

If you’re choking because of paralyzed vocal cords, you may not be able to dislodge a trapped object or breathe. If you’re choking and can’t speak, contact emergency medical assistance immediately.

Some people are at a higher risk for vocal cord paralysis than others.

Chest and throat surgery

People who’ve had recent surgery at or around the area of the larynx can end up with damaged vocal cords. Being intubated during any surgery can also damage your vocal cords. Thyroid, esophagus, and chest surgeries all carry some risk of damaging your vocal cords.

A small study from 2007 indicated that having intubation over the age of 50 and being intubated for more than six hours increased risk of vocal cord paralysis developing after surgery.

Neurological conditions

Vocal cord paralysis happens because of misfiring or damaged nerves. Neurological conditions, such as Parkinson’s disease and multiple sclerosis (MS), can cause this kind of nerve damage. People with these conditions are also more likely to experience vocal cord paralysis.

Vocal cord paralysis is usually triggered by a medical event or another health condition. These include:

  • injury to chest or neck
  • stroke
  • tumors, either benign or malignant
  • inflammation or scarring of the vocal cord joints due to strain or infection
  • neurological conditions, such as MS, Parkinson’s disease, or myasthenia gravis

Vocal cord paralysis needs to be diagnosed and treated by a medical professional. There’s no at-home treatment for this condition that you should attempt before seeing a doctor.

Voice therapy

Sometimes vocal cord paralysis resolves on its own within a year. For this reason, a doctor may recommend voice therapy to try to restore nerve communication between your brain and your larynx before recommending surgery.

Certified speech-language pathologists assist in this treatment. Voice therapy aims to improve the function of your vocal cords through simple repetitive exercises that retrain the vocal cords. Exercises aim to change the way that you use your voice and instruction on different ways to breathe.

Surgery

If voice therapy doesn’t help, your doctor may recommend surgery. If both of your vocal cords are experiencing the paralysis, your doctor may recommend surgery right away.

Vocal cord injection

This procedure involves using injectable material to make your vocal cord bulkier and easier to move. This kind of injection is performed through the skin that covers your larynx.

A laryngoscope is put into your throat so the person performing the injection can insert the material in the correct place. It can take a few minutes for the material to evenly fill the vocal fold. After this type of surgery, you are typically discharged to go home right away.

Phonosurgery

Phonosurgery changes the location or shape of your vocal cords. This surgery is performed when only one vocal cord is paralyzed.

Phonosurgery moves your paralyzed vocal cord toward the one that still has nerve function. This enables you to produce sound through your voice box, and swallow and breathe more easily. You’ll need to stay overnight in the hospital and will most likely have an incision on your neck that’ll need care as it heals.

Tracheotomy

If both your vocal cords are paralyzed toward the middle section of your larynx, you may need a tracheotomy. Also called a tracheostomy, this surgery creates an opening in your neck to directly access your trachea, or windpipe. The tube is then used for breathing and for clearing secretions from your windpipe.

This surgery is only performed when paralyzed vocal cords keep you from being able to properly breathe, swallow, or cough, putting you in danger of suffocation. Sometimes a tracheostomy tube is permanent.

If you have vocal cord paralysis, recovery will depend on the cause.

For some people, voice exercise one to two times a week for four to six months can correct the condition enough for speaking and swallowing normally. While voice exercise may not repair paralyzed vocal cords, you may be able to learn methods of breathing and speaking that allow you to communicate with your voice.

If your paralyzed vocal cords require surgery, recovery may look different. You may need to rest for 72 hours, being careful not to use your voice at all during that time, as your larynx begins the healing process. Two or three days of drainage from the site of the wound is normal, though it’s important to watch carefully for any strange colors or smells that could indicate infection.

After surgery, your voice may not sound better right away. You’ll need to work with a speech-language pathologist after your surgery to develop a new way of speaking that accounts for changes in your vocal cords.

Treating vocal cord paralysis doesn’t always result in your vocal cords regaining their previous abilities. Since the causes of vocal cord paralysis involve nerve damage or progressive health conditions, correcting the paralysis itself may be difficult.

The symptoms of vocal cord paralysis are usually very treatable, though there’s no quick fix. A treatment plan from your doctor and a supportive speech-language pathologist will give you the best chance to recover your ability to eat, speak, and swallow.