Division of Voice and Swallowing

Vocal Fold Paralysis

What Is Vocal Fold Paralysis?

Vocal fold paralysis is a voice disorder that occurs when one or both of the vocal cords (or vocal folds) do not open or close properly. Vocal fold paralysis is a common disorder, particularly among the elderly, after certain types of surgery, and symptoms can range from mild to life threatening. Typically vocal cord paralysis causes a breathy or hoarse voice and an inability to project the voice loudly.

The vocal folds are two muscles tissue located in the larynx (voice box) directly above the trachea (windpipe). The vocal folds produce voice when air held in the lungs is released and passed through the closed vocal folds, causing them to vibrate. When a person is not speaking, the vocal folds remain apart to allow the person to breathe.

Someone who has vocal fold paralysis often has difficulty swallowing and coughing because food or liquids slip into the trachea and lungs. This happens because the paralyzed cord or cords remain open, leaving the airway passage and the lungs unprotected.

What Causes Vocal Fold Paralysis?

Vocal fold paralysis may be caused by a variety of disorders, diseases, or injuries. These disorders can either directly interfere with the mechanical movement of the vocal fold, or they may impact the recurrent laryngeal nerve, the nerve that stimulates the muscles of the vocal fold. Most often, vocal fold paralysis is caused by the latter.

Impairment of the Laryngeal Nerve

Mechanical Impairment of the Vocal Folds

Symptoms of Vocal Fold Paralysis

People who have vocal fold paralysis experience abnormal voice changes, changes in voice quality, and discomfort from vocal straining. For example, if only one vocal cord is damaged, the voice is usually hoarse or breathy. Changes in voice quality, such as loss of volume or pitch, may also be noticeable. Damage to both vocal cords, although rare, usually causes people to have difficulty breathing because the air passage to the trachea is blocked. Individuals with vocal cord paralysis may also experience dysphagia, or swallowing problems, because the food and liquid can be aspirated into the airway.

Information on surgical treatment of vocal cord paralysis

Depending on the cause of the severity of the problem, vocal fold paralysis may be treated surgically or through exercises provided by a Speach and Language Pathologist.

Sources: This page was adapted in part from a patient handout sheet published by the National Institute on Deafness and Other Communication Disorders (NIDCD), available at www.nih.gov.


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