You might have vocal cord paralysis. When your vocal cords (folds) don’t work right, it can really play havoc with your world. You might not recognize your own voice or you might run out of breath in the middle of a sentence. Swallowing and breathing can be a problem. Maybe you even shy away from working or spending time with friends because it’s frustrating to talk — or your whisper of a voice makes it hard to even hear you.
Don’t worry. The specialists at Cleveland Clinic can help rehabilitate your voice box (larynx). We’ll work with you to find a treatment option that fits your needs. Along the way, we’ll be there to answer your questions and ease any fears. We want to help you find your voice and make breathing and eating easier again.
Why Choose Cleveland Clinic for Vocal Cord Paralysis Care?
Our compassionate healthcare providers understand how frustrating and draining it can be when your vocal cords don’t work the way they should. We’ll listen to your concerns, answer your questions and put together a treatment plan that’s right for you. We’ll also video record all your throat exams so we can show you exactly what’s going on and explain what we see.
Your care team are specialists who help people with vocal cord disorders and paralysis. A laryngologist (voice box and throat specialist) will typically lead the team, often with the help of a speech-language pathologist. Meet our team.
Most of the time, you can be treated right in your provider’s office. We’ll also make sure you’re as comfortable and pain-free as possible during procedures. And the best part? Our therapies can often make your voice sound better right away.
We specialize in minimally-invasive vocal cord procedures, like vocal cord injection and innovative surgeries like medialization laryngoplasty and laser cordotomy.
We make it easy for you to get the care you need. Many of our healthcare providers offer virtual visits and follow-ups. You’ll get quality, one-on-one care from your provider from the comfort and convenience of home. All you need is a smartphone, tablet or computer.
U.S. News & World Report consistently ranks Cleveland Clinic a top hospital in the nation. Newsweek has also named us a top hospital in the world.
Vocal Cord Paralysis Diagnosis at Cleveland Clinic
Finding out what’s wrong and starting treatment right away gives you a better chance of getting your vocal cords back in working order as soon as possible. Even if you think a problem may get better on its own, we’ll work to make your voice stronger and have you breathing easier while we wait for your paralyzed vocal cord or cords to recover.
At your appointment, we’ll ask how you’re feeling, what you’re experiencing and your medical history. We’ll look at pictures of your throat and neck using imaging tests, such as a CT scan, X-ray or MRI.
Getting a close look at your vocal cords is extremely helpful. To help see what’s going on, your provider may do a laryngoscopy with stroboscopy. This procedure uses a thin tube with a camera on the end to take a closer look at your throat and vocal cords. Stroboscopy lets us to see how well your vocal cords vibrate and close. We may also do an electromyogram. This test lets us looks at how well your vocal fold nerves are working and the chances for recovery.
It’s more common to have unilateral (one-sided) vocal cord paralysis as a result of some neck surgeries. This will usually affect your voice, but it can also make it hard to swallow and cause shortness of breath when you’re trying to talk. Bilateral (two-sided) vocal cord paralysis is rare. It typically causes shortness of breath even when you’re resting and especially with activity.
Who Treat Vocal Paralysis
Vocal Cord Paralysis Treatment at Cleveland Clinic
Our goal is to rehabilitate your voice so you feel and sound like yourself again. Treatment can also help you breathe and swallow better. You and your provider will decide together on what therapy or combination of therapies works best for you. We offer:
For mild voice impairment with vocal cord paralysis, your provider may recommend voice therapy with a specially trained speech-language pathologist. Voice therapy helps you adjust to the change in your voice. During your sessions, we’ll help you focus on your breathing and the effort it takes to have your voice work as close to normal as possible. Therapy may also help you breathe easier when you talk.
Vocal cord injections
Our specialists inject a filler material into your paralyzed vocal cord. This pushes it to the middle, making it easier to make contact with your “working” vocal cord and improve your voice. A vocal cord injection can be done in the operating room or in your healthcare provider’s office. You can have vocal cord injections every three months while we wait for your vocal cords to recover.
We also offer injections which use fat tissue from your body to close the gap, which may last longer. A new injection material made from silk protein is available for some patients and may be a longer term solution.
Vocal Cord Surgery at Cleveland Clinic
If your vocal cord paralysis has lasted longer than 10 to 12 months, we may talk to you about having surgery. We know surgery may sound scary, but the fast results you feel — and hear — can be worth it. We offer:
Medialization laryngoplasty (formerly known as thyroplasty)
Your surgeon uses a custom silicone or GORE-TEX implant to close the gap between your vocal cords by moving the paralyzed vocal cord closer to the working one. By having you talk throughout the procedure, we figure out the best size and position of the implant for your voice and can see how our actions affect your voice in real time.
Laryngeal re-innervation: Unilateral (one vocal cord)
Vocal cord paralysis happens when the nerve that makes your vocal cord move is injured. In this procedure, we use a nearby nerve to provide a new nerve signal to your vocal fold. This procedure doesn’t make the cord move again but does provide tone and positions the cord for speaking. This procedure can be a good option if you don’t want an implant or would rather be asleep during surgery.
In the rare situation that both of your vocal cords are in the middle of your airway and can’t open for normal breathing, your surgeon may recommend airway surgery. In this situation, breathing is more important than speaking.
You may need a tracheostomy to help you breathe right away if both vocal cords are paralyzed (bilateral vocal cord paralysis). During this procedure, your provider makes an incision (cut) and inserts a tube into your throat. The tube opens your airway and helps you breathe.
Vocal cordotomy/Medial partial arytenoidectomy
Your surgeon does this minimally invasive endoscopic procedure in the operating room. They remove part of one vocal cord to open your airway. While this procedure will affect your voice, the goal is to improve breathing and help to prevent or become free of a tracheostomy.
Taking the Next Step
If one or both of your vocal cords is paralyzed, talking, swallowing — even breathing — can be much harder. You may have many questions, worries and fears about this condition. Our voice specialists can help. With the right treatment, we can help you find your voice again and breathe easy.
Getting an appointment with Cleveland Clinic vocal cord paralysis experts is easy. We’re here to help you get the care you need.
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