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Vocal Cord Paralysis

Vocal cord paralysis is when one of the two vocal cords does not move, causing a weak voice and difficulty swallowing.


Symptoms of vocal cord paralysis include:

  • Weak and breathy voice
  • Poor voice projection or difficulty making loud sounds
  • Vocal fatigue or voice tiring easily
  • A weak cough and frequent throat clearing
  • Difficulty swallowing certain foods, with a sensation of foods "going down the wrong pipe"
  • Feeling out of breath after speaking


Normally, we have two vocal cords that move together to make sound. The signal from the brain to the vocal cord is transmitted through the recurrent laryngeal nerve.

Although there are a number of causes of vocal cord paralysis, most occur when the nerve does not work due to:

  • A surgery along the course of the nerve, including brain, thyroid, spine and lung surgery
  • Inflammation, often following an upper respiratory infection
  • A mass or tumor growing next to or involving the nerve

Diagnosis and treatment

Diagnosis of vocal cord paralysis occurs during a laryngoscopy and stroboscopy, which your physician uses an endoscope to evaluate the vocal cords. Often, a CT scan is ordered to determine the cause of the paralysis.

Vocal cord paralysis treatment usually involves one of the following:

Vocal cord injection

A vocal cord injection is a procedure in which a filling agent such as collagen "bulks" the paralyzed vocal cord. Physicians at the UCI Health University Voice & Swallowing Center are able to perform this procedure while you are awake, avoiding the need for general anesthesia and providing immediate improvement in the voice.


Thyroplasty is a surgery that provides excellent long-term improvement of the voice. During this procedure, a small plastic implant is made and inserted into the voice box. This moves the paralyzed vocal cord into a position where it can work and make sound.

Laryngeal reinnervation procedure

Laryngeal reinnervation is a surgery that was developed at UC Irvine. During this procedure, a donor nerve is connected to the recurrent laryngeal nerve. In time, the tone of the paralyzed vocal cord will improve.

Voice therapy

Treatment for vocal fold paralysis often also involves voice therapy with one of our speech and language pathologists.

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