Paralysed Vocal Cords

There are two vocal cords in your larynx (voicebox). During speech the vocal cords vibrate to produce sound or voice.

Vocal cord paralysis or paresis results from abnormal nerve input to the muscles in the voice box. These are the laryngeal muscles. Paralysis is the total interruption of the nerve impulse and this results in no movement at all. Paresis is the partial interruption of the nerve impulse and this results in weak or abnormal motion of the laryngeal muscles.  Paralysis or paresis can happen at any age, from the very young to the elderly.


Causes of Paralysed Vocal Cords

In about half of all cases of all vocal cord paralyses, the cause will remain unknown. This is called idiopathic which means due to unknown origins.

Other causes may be:

  • Damage to the vagus nerve
  • Viral infections
  • Head and neck injuries
  • Tumours
  • Stroke


Both paralysis and paresis of the voice box muscles results in voice changes and may also result in difficulty in swallowing and airway difficulties.

  • Voice Changes: Hoarseness, breathy voice, inability to speak loudly, and voice that sounds like a gargle (dilophonia).
  • Swallowing Problems: Choking or coughing while eating or drinking or swallowing saliva.
  • Airway Problems: Noisy breathing, shortness of breath and an ineffective cough.


Dr Katzen will take a thorough history and ask you questions about you and your symptoms and lifestyle.  Your vocal cords are examined and we use an endoscope that is inserted through the mouth. The endoscope has a fibre optic light and this allows us to view the vocal cords and the movement patterns of the cords during phonation (producing sound) and at rest.  A complete voice evaluation is conducted.

Treatment of Paralysed Vocal Cords

The two treatment options to improve the vocal function are voice therapy (this is like physical therapy) and phonosurgery, which is an operation that reshapes and/or repositions the vocal cords to improve voice function.

Voice therapy is usually the first option. Surgery may be the second option depending on how severe the symptoms are, the vocal needs of the patient and the position of the vocal cords.