Diagnosis

Your doctor will ask you detailed questions about your voice problems and examine you thoroughly. A topical anesthetic may be applied to numb your tissues before your doctor uses one of the following tools to examine your vocal cords:

  • Mirror. Similar to a dental mirror, a long, rigid instrument with an angled mirror is inserted into your mouth.
  • Flexible laryngoscope. A flexible tube containing a light and camera is inserted through your nose.
  • Rigid laryngoscope. A rigid viewing tube is inserted through your mouth.
  • Videostroboscope. A camera is combined with a flashing light to provide a slow-motion view of your vocal cords as they move.

Additional tests are sometimes used:

  • Sound (acoustic) analysis. Using computer analysis, your doctor can measure irregularities in the sound produced by the vocal cords.
  • Laryngeal electromyography. Small needles are inserted through the skin to measure the electric currents in your voice box muscles.

Treatment

Depending on your diagnosis, your doctor will recommend one or more treatments:

  • Rest, liquids and voice therapy. Like any other part of the body, the vocal cords need regular rest and fluids. Speech pathology specialists can teach you how to use your voice more efficiently through voice therapy, how to properly clear your throat and how much liquid to drink.
  • Allergy treatments. If an allergy is creating too much mucus in your throat, your doctor or an allergy specialist can identify the allergy's cause and provide treatment.
  • Smoking cessation. If your voice problem is the result of smoking, quitting smoking can help improve your voice along with many other areas of your health, such as boosting your heart health and lowering your cancer risk.
  • Medications. Several medications are available for treating voice disorders. Depending on the cause of your voice disorder, you may need medication to reduce inflammation, treat gastroesophageal reflux or prevent blood vessel regrowth. Medications can be taken orally, injected into the vocal cords or applied topically during surgery.

Procedures

  • Removal of lesions. Noncancerous lesions (polyps, nodules and cysts) on the vocal cords may need to be surgically removed. Your doctor can remove noncancerous, precancerous and cancerous lesions — including recurrent respiratory papillomatosis and white patches (leukoplakia) — using microsurgery, carbon-dioxide laser surgery, and when appropriate, the newest laser treatments, including potassium titanyl phosphate (KTP) laser treatment.

    KTP laser treatment is a state-of-the-art therapy that treats lesions on the vocal cords by cutting off the blood supply to the lesion, allowing the lesion to be removed while preserving the maximum amount of underlying tissue.

  • Botox injections. Injections of tiny amounts of purified botulinum toxin into your neck skin can decrease muscle spasms or abnormal movements if you have a neurological movement disorder that affects the vocal muscles of the larynx (spasmodic dysphonia).

Sometimes one vocal cord may stop moving (become paralyzed). If you have one paralyzed vocal cord, you might often complain of hoarseness. You might also complain of choking when you drink liquids, but rarely have trouble swallowing solid foods. Sometimes the problem goes away with time.

If not, one of two procedures can be used to push the paralyzed vocal cord closer to the middle of the windpipe so that the vocal cords can meet and vibrate closer together. This improves the voice and allows the larynx to close when you swallow. Treatments include:

  • Fat or collagen injection. Body fat or synthetic collagen is injected, either through your mouth or the skin on your neck, to add bulk to the paralyzed vocal cord or to treat vocal cord weakness. The material fills the space next to your vocal cord and pushes it closer to your other vocal cord, allowing them to vibrate more closely together.
  • Thyroplasty. A small opening is created in the cartilage from the outside of your voice box. The doctor inserts an implant through the opening and pushes it against the paralyzed vocal cord, moving it closer to your other vocal cord.

Read more about vocal cord paralysis treatment and allergies at Mayo Clinic.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Voice disorders care at Mayo Clinic

Nov. 18, 2017
References
  1. Bruch JM. Hoarseness in adults. https://www.uptodate.com/home. Accessed May 13, 2017.
  2. Vocal cord paralysis. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/vocal-fold-paralysis. Accessed May 13, 2017.
  3. Voice reference guide. The Voice Foundation. http://voicefoundation.org/health-science/voice-disorders/. Accessed May 13, 2017.
  4. Common problems that can affect your voice. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/content/common-problems-can-affect-your-voice. Accessed May 14, 2017.
  5. Kallvik E, et al. Vocal symptoms and voice quality in children with allergy and asthma. Journal of Voice. In press. Accessed May 13, 2017.
  6. Mascarella MA, et al. In-office excision en masse of a vocal process granuloma using the potassium-titanyl-phosphate laser. Journal of Voice. 2016;30:93.
  7. Koss SL, et al. Serial in-office laser treatment of vocal fold leukoplakia: Disease control and voice outcomes. The Laryngoscope. In press. Accessed May 13, 2017.
  8. Warner KJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. March 3, 2017.
  9. Ekbom DC (expert opinion). Mayo Clinic, Rochester, Minn. May 18, 2017.