Vocal Cord Palsy

There are several methods for treating vocal cord palsy, among them surgery and voice therapy. In some cases, the voice returns without treatment during the first six months after damage. For that reason, doctors often delay permanent corrective surgery for at least six months to allow for spontaneous recovery. During this time, the suggested treatment is usually voice therapy and sometimes injecting the vocal cord with temporary bulking agents. Speech therapy may involve exercises to strengthen the vocal cords or improve breath control during speech.

Surgery involves injecting bulk to the paralyzed vocal cord or changing its position. To add bulk, an otolaryngologist injects a substance, either temporary, or permanent, into the paralyzed vocal cord. This is done with a needle and syringe and does not require an incision. Other substances currently used are collagen, a structural protein; silicone, a synthetic material; and body fat. The added bulk reduces the space between the vocal cords so the nonparalyzed cord can make closer contact with the paralyzed cord and thus improve the voice. 

Sometimes, a procedure called medialization laryngoplasty / thyroplasty is performed. This procedure permanently shifts a paralyzed cord closer to the center of the airway to improve voice and swallowing. This is done with a permanent implant through an incision in the neck using implants.

Treating people who have both vocal cords paralyzed may involve performing a surgical procedure called a tracheostomy to help breathing. In a tracheostomy, an incision is made in the front of the patient’s neck and a breathing tube (tracheostomy tube) is inserted through a hole, called a stoma, into the windpipe.