Vocal Cord Paralysis/ Paresis

If Your Voice Is Weak, Sounds Breathy, and Tires Easily, You May Have a Partial Nerve Disruption Called Vocal Cord Paresis

Woman with a breathy tired voice


Location of the vocal cords - vocal cord paralysis

What’s the Difference Between Vocal Cord Paralysis and Vocal Cord Paresis?

Vocal cords are a pair of tissue folds in the throat that vibrate to produce the sound of your voice.

Vocal cord paralysis occurs when nerve impulses to the voice box (larynx) are completely disrupted. It can affect one’s ability to speak and breathe. If there is partial disruption of the nerve, then the condition is referred to as vocal cord paresis. The result is a weakened voice that sounds breathy and tires easily.

Vocal cord paralysis not only prevents you from emitting normal vocal sounds but it can also create challenges while swallowing. Since vocal cords sit atop the trachea (windpipe), they fold closed when ingesting food, drink, and mouth saliva. If either or both of the folds don’t close all the way, food, drink, or saliva will “go down the wrong pipe” and cause choking, coughing, and gasping.



Causes of Vocal Cord Paralysis

Vocal cord paralysis does not discriminate. It can affect males and females of any age, from birth to old age.

There are many causes of vocal cord paralysis:

  • Nerve damage during neck surgery
  • Complication from endotracheal intubation
  • Blunt neck or chest trauma
  • Tumors of the skull base, neck, and chest
  • Infections such as Lyme disease, Epstein-Barr virus and herpes
  • Certain cancers
  • Stroke
  • Neurological conditions such as multiple sclerosis or Parkinson’s disease

Symptoms of Vocal Cord Paralysis

In most cases, only one vocal cord is paralyzed.

Some symptoms of vocal cord paralysis can include:

  • A breathy or hoarse voice
  • Loss of vocal pitch
  • Choking, coughing, or gasping when ingesting food, drink or saliva
  • Frequent breaths while speaking
  • Speaking softly or weakly
  • Ineffective coughing
  • Frequent throat clearing

Treatment of Vocal Cord Paralysis

Unfortunately, there aren’t treatments to make the injured nerve work better. But we can change the shape of or reposition the paralyzed vocal cord so that it works better with its normal partner (the unaffected vocal cord). Treatment for vocal cord paralysis/ paresis can include:

  • Voice therapy
  • Vocal cord augmentation with injections (gel or paste)
  • Vocal cord augmentation with implants

More On Injections to Treat Vocal Cord Paralysis/ Paresis

We commonly perform injections to treat vocal cord paralysis and paresis.

We recently performed an injection medialization laryngoplasty whereby gel was injected into the paralyzed vocal cord of a patient. The injection increased the volume of the paralyzed vocal cord so the functioning vocal cord could meet it to initiate vibration (and thus, sound).

In the “before” section of the video, you can hear the breathy, weak voice of the patient while he reads The Rainbow Passage.

In the “after” section of the video, the patient has his strong voice back and you witness the incredible success of injection medialization laryngoplasty performed by BergerHenry ENT.

Vocal Cord Paralysis Strobe Exam

Through This Strobe Exam of a Patient’s Throat, See What Vocal Cord Paralysis Actually Looks Like

When to Call BergerHenry ENT
If you have an unexplained weakening of the voice, voice discomfort, or persistent hoarseness for more than two weeks, call BergerHenry ENT at (610) 279-7878.