Voice Disorders

Vocal Cord Paralysis

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For various reasons, one vocal cord may become paralyzed and stop moving. The vocal cords (also called vocal folds) are located in the voice box (larynx) and are responsible for the voice and helping to close the voice box during swallowing to prevent aspiration. People with one paralyzed vocal cord often complain of choking when drinking liquids, but they rarely have difficulty swallowing solid foods. Fortunately, the problem with swallowing liquids usually resolves over time and requires no treatment.

However, if swallowing problems persist for months, a vocal cord medialization procedure may be helpful. This procedure simply pushes the paralyzed vocal cord to the middle so that the functioning, moving vocal cord can close off the larynx during swallowing. This procedure improves both voice and swallowing. It is usually done by a physician in the Department of Otorhinolaryngology.

Vocal cord medialization procedures help only with voice quality and swallowing liquids; swallowing solid foods is generally not improved. There are two kinds of vocal cord medialization procedures:

• Injection. The surgeon injects a material into the paralyzed vocal cord, either through the mouth or through the neck skin. The material fills the vocal cord and pushes it to the midline. This can be done as an inpatient or outpatient procedure.
• Surgery (thyroplasty). A window of cartilage is removed from the outside of the voice box. Then, a precisely measured piece of solid silicone is inserted through the window and pushed against the paralyzed vocal cord, moving it to the midline. Thyroplasty is almost always done in the hospital under local anesthesia.