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Vocal Cord Paralysis


  • Vocal cord paralysis means that the vocal cords are frozen in place -- stuck in a fixed position.  The vocal cords are part of the "voice box" and consist of two cords side-by-side near the Adam's apple.  They remain open during normal breathing, and close to create sound during speech.  Vocal cord paralysis may be attributed to a number of factors.  The severity and nature of the symptoms depend on how quickly the cords become paralyzed.  One or both of the cords can be involved.  If only cord is paralyzed, it is usually the left cord that is affected.

  • Symptoms depend on:
    1. How quickly the cords become paralyzed
    2. Whether one or both of the cords are involved
  • If only one vocal cord is paralyzed, it can cause a hoarse voice with a "breathy" character.  It usually does not cause shortness of breath.
  • If both cords are paralyzed, the symptoms are determined by the speed of onset of paralysis.  If slow onset, there may be no symptoms at all and speech is normal.
  • If both cords are paralyzed suddenly, shortness of breath follows.  This is an emergency -- call 911 immediately.

  • It is usually due to damage to the nerve which helps open and close the vocal cords.
  • It can be caused by birth trauma.
  • If only one vocal cord is paralyzed, it is usually due to thyroid surgery or a tumor in the chest or lungs.
  • If both vocal cords are paralyzed, it is usually due to thyroid surgery, neck Injury, central nervous system disease such as Chiari malformation, or a very aggressive cancer in the neck.  Less often, the problem is caused by arthritis of the bones in the "voice box."

  • Diagnosis is usually made by the symptoms.
  • Once the patient is stable, his vocal cords may be examined using a small laser camera.

  • If only one cord is paralyzed, no treatment may be needed.  If the person is hoarse, then Teflon can be injected into the vocal cord, or surgery can be done to help with the symptoms, but in some cases the voice can return without treatment.

  • If your child is short of breath, this is an emergency and you must call 911.
  • If both cords are paralyzed, the first consideration is to ensure that your child can breathe.  In an emergency, a hole (tracheostomy) can be made in the neck through which he/she can breathe temporarily.  After he/she is stable, another surgery may be performed later to correct paralysis.



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