Dos
- Do seek assessment promptly if your voice changes suddenly, especially after neck or chest surgery
- Do follow swallowing advice closely if choking on liquids is a symptom
Vocal Cord Paralysis
Consultant-led diagnosis and treatment for vocal cord paralysis, where one or both vocal cords lose normal movement.
What is the condition?
Vocal cord paralysis happens when the nerve supply to one or both vocal cords is disrupted, most often affecting a single side. Causes include surgery near the nerve (particularly thyroid or chest surgery), viral infection, tumours, or in some cases no cause is found. When a cord cannot move properly, it may not close fully against the other cord, affecting both voice and, in some cases, swallowing and breathing.
Symptoms
What to look out for?
Symptoms depend on how well the two vocal cords can still meet in the middle, and range from a breathy voice to swallowing difficulty.
- A weak, breathy or hoarse voice
- Voice that tires quickly or runs out of breath when talking
- Coughing or choking when swallowing liquids
- In some cases, noisy breathing (stridor)
Treatment
What can be done?
Some paralyses recover on their own over months and are initially monitored with voice therapy. Where recovery is unlikely or the voice remains poor, options include injection augmentation to bulk out the paralysed cord, thyroplasty to reposition it permanently, or laryngeal re-innervation surgery in selected cases.
- Voice therapy while natural recovery is monitored
- Vocal cord injection augmentation
- Thyroplasty
- Laryngeal re-innervation surgery
Prevention
What should I do?
Don'ts
- Don't assume a persistent breathy voice will simply resolve without assessment
- Don't delay review if swallowing safety is a concern