What are vocal folds?
Vocal cords (also known as vocal folds) are composed of twin infoldings of mucous membrane stretched horizontally across the larynx. They vibrate, modulating the flow of air being expelled from the lungs during phonation. Vocal cords are open during breathing. They are closed during speech or singing.
What is vocal fold paresis/paralysis?
Vocal cord paresis/paralysis occurs when one or both of the vocal cords do not move. Vocal cords can be partially or completely paralysed. Paralysis may affect one or both of the vocal cords. This paralysis causes a gap between the two cords, allowing air to escape and the disruption of regular vibration.
What are the symptoms?
Symptoms will vary depending on whether one or both cords are affected and/or the position which the cords are in. Symptoms of vocal cord paresis may include:
- Breathy or weak vocal quality
- Complete loss of voice
- Variable pitch and tone of voice
- Decreased volume capacity
- Difficulty making yourself heard when there is lots of background noise
- Shortness of breath
- Swallowing difficulties
What causes vocal fold paresis/paralysis?
Vocal cord paresis/paralysis occurs due to damage to one of two nerves that innervates the larynx (voice box). The most common nerve affected is the recurrent laryngeal nerve. Nerve damage can result from surgeries (Inc spinal fusion, cardiac, thyroid and pulmonary). Nerve damage can also occur as a result of a viral infection. Viral damage to the laryngeal nerve (with subsequent paresis) can occur without any other symptoms of the virus.
What treatments are available?
An Ear, Nose and Throat doctor will be able to diagnose vocal cord paralysis. Some paralysed cords may recovery without intervention. There is however, the possibility of permanent paralysis. Treatment choices vary and will depend on the nature of the paralysis, the cause and your voice needs.
Functional voice therapy is often effective. Surgical options are also available in cases where further treatment is required. Optimal management plans are developed in consultation with your ENT doctor and speech therapist.
