VOCAL CORD PARALYSIS

VOCAL CORD PARALYSIS

How is vocal cord paralysis treated?

Treatment of vocal cord paralysis depends on how long the paralysis has been present and the etiology of the paralysis. In general, after a vocal cord paralysis has occurred, the nerve has up to a year to recover. After this period of time, if recovery has not happened, it is unlikely to recover. 

Temporary Options: Injection Laryngoplasty (Vocal Cord Injection) and Voice Therapy

There are temporary treatment options that can be performed while we are waiting to determine if the vocal cord nerve will recover. These options include voice therapy and injection medialization laryngoplasty (vocal cord injection). These treatment options often work best if performed together. 

Voice therapy is the least invasive option and helps you to learn strategies to compensate for your immobile vocal fold.

Vocal cord injection can be performed in the office in most patients. This requires just local numbing medication to the vocal cords and takes only a matter of minutes. The injected material pushes the immobile vocal fold into a more medial position so that it can make contact with the other vocal cord. This reduces the amount of air escaping between the vocal cords. This will strengthen your voice, reduce vocal effort, and decrease risk of aspiration.

Permanent Options

If you have had a long standing paralysis or enough time has passed that we believe vocal cord paralysis has become permanent, there are permanent options for vocal cord medialization.

A permanent implant (silastic or goretex) can be placed through a small incision in your neck into the larynx (voice box). The procedure is performed under mild sedation, so that we can confirm the change in your voice right away. The procedure is outpatient with no voice or diet restrictions post-operatively. 

An arytenopexy is required for patients with a large gap between their vocal cords. This procedure involves repositioning of the vocal cord joint (arytenoid). If this procedure is required, patients are generally observed in the hospital overnight.

Reference: Zeitels, SM., Adduction arytenopexy: a new procedure for paralytic dysphonia with implications for implant medialization. Ann Otol Rhinol Laryngol Suppl. 1998 Sep;173:2-24.