Vocal cord paralysis
Duke voice care specialists use the latest medical and surgical advances to treat vocal cord paralysis and strengthen your voice.
When the nerve responsible for vocal cord movement is damaged or injured, vocal paralysis may result. A variety of conditions can damage the nerve, including trauma, surgical injury, stroke, a virus, and voice box tumors. Paralysis can affect the ability of one or both of your vocal cords to open and close properly. Depending on the severity of the damage, and the extent of the paralysis, you may experience a breathy, weak or soft voice, as well as difficulty swallowing and breathing. If both vocal cords are paralyzed, you will have difficulty breathing. The damage to the nerve, and its ability to recover, will impact the severity of your voice disorder.
Vocal cord atrophy (weakened vocal cords) can happen as a normal part of aging, without vocal cord paralysis. If you have aging vocal cords, you may notice that your voice has become weak, a condition known as vocal cord atrophy. Our comprehensive team of voice specialists uses the latest diagnostic technology to identify the severity of your vocal cord paralysis or vocal cord atrophy, and recommend the most appropriate combination of treatments and therapy to help you overcome any difficulties you experience with breathing, swallowing and speaking. We offer the best possible care to improve your vocal function as quickly as possible.
Choose Duke to treat your voice disorders because we offer:
- Voice disorder specialists. We are one of the few voice centers in the Southeast, with a comprehensive team of voice experts. Your team includes ear, nose, and throat (ENT) physicians who are laryngologists, a specialty that requires advanced training in voice disorders.
- Highly specialized speech pathologists. Our speech pathologists undergo specialized training to evaluate and treat patients with voice problems, swallowing disorders, and complex conditions such as voice restoration after throat cancer. Our team also includes trained singing voice specialists. They are experienced performers, singers, and singing teachers who understand the challenges of being a vocal professional. They bring empathy, clinical expertise, and an insider perspective to evaluating and improving your vocal health. They also provide specialized therapy to performers and singers.
- Less invasive, less costly techniques. We use less invasive, less costly techniques, such as office-based based injections to “bulk up” a paralyzed vocal cord. We also offer a variety of surgical options for vocal cord paralysis.
- Coordinated care. We coordinate your care with the right specialists throughout our health system to ensure you receive the best therapies to minimize your symptoms, improve your voice, and optimize your recovery.
- Treatment for all laryngeal conditions. Your voice box, or larynx, is responsible for your voice, your ability to swallow, and your airway or breathing passage. All of these functions may be impacted by vocal cord paralysis. Our doctors and speech pathologists treat voice, upper airway breathing problems and swallowing disorders.
- Better treatment decisions. Our ongoing research ensures you receive the best care for your vocal cord paralysis.
VOCAL CORD PARALYSIS
Improves your speaking voice technique, pacing, and vocal hygiene. You work with a speech pathologist who guides you through vocal exercises to improve breathing, reduce throat strain, find your optimal pitch and volume for strong, healthy speaking. We work with you to get your voice back and to meet your daily voice needs. Voice therapy can be customized for specific needs.
- Professional vocal performers. Vocal exercises and therapy improve your vocal range, endurance, and voice quality, while also helping heal vocal injuries and protect you against re-injury. Our singing voice specialists teach you to maintain vocal health as well as strategies to return you to your highest level of vocal performance, and perhaps even enhance it. We often work with high-level performers who need immediate vocal services.
An implant (like a tiny shim) is placed through the voice box to reposition the paralyzed vocal cord and produce a stronger voice. Also known as "medialization laryngoplasty" or "laryngeal framework surgery,” this procedure requires a small incision in the neck. Thyroplasty is often recommended when the paralysis appears permanent and the voice is very weak and breathy.
Helps the vocal cords close better and improves the chronically weak, hoarse, breathy voice caused by vocal cord paralysis. A small amount of fat is removed from your belly and injected via a tiny needle to permanently plump specific areas of the vocal cords. The procedure is performed under general anesthesia. A repeat injection is sometimes needed, since some fat is reabsorbed by the body.
Injectable fillers add bulk to the vocal cords when they have lost muscle tone due to aging or vocal cord paralysis. A tiny needle loaded with Cymetra or Gelfoam is inserted via a tiny tube through the nose into the throat, so the vocal cords can be injected. The injection creates a stronger voice. This can be done in the operating room, or during an office visit under local anesthetic, with an injection through the neck. These fillers are reabsorbed by the body over time.
Surgically corrects the position of the vocal cord for better vocal cord closure and stronger voice. Sometimes used in combination with thyroplasty.
Surgically reconnects a nerve to the weakened vocal cord muscle. This restores the vocal cords' tone and bulk, which makes the voice stronger.
VOCAL CORD PARALYSIS
Assesses your voice use patterns - how much you speak, sing, or use a loud voice, and what your voice sounds like. Your laryngologist will evaluate the role of any of your medical conditions that can cause voice changes, such as surgeries and recent illness. If chronic cough is a concern, your breathing or cough symptoms and other triggers will be evaluated. A head and neck examination is performed. A visual examination of the voice box is also completed.
This visual exam evaluates how your vocal cords vibrate while you make sounds. A tiny camera attached to a small tube called an endoscope is inserted through your nose to the top of the throat. This camera uses a flashing strobe light to capture slow motion images of your vocal cords. You will be able to see these images, which are analyzed to reveal growths, stiffness, paralysis, irregular movements, throat strain, and incomplete closure of the vocal cords. Videostroboscopy is often essential to reach an accurate voice diagnosis.
Creates a visual display on a computer screen as you speak into a microphone. Allows you and your speech pathologist to see characteristics of your voice, including pitch, loudness, and vocal quality (including hoarseness and breathy voice). It is used to identify abnormalities, including subtle vocal problems that cannot be detected with the unaided ear. It may be repeated during treatment to monitor your progress. This exam is usually completed on your second visit.
May be used to evaluate the larynx nerves and muscles by analyzing their electrical activity. As you lie on your back, small, thin electrode needles are placed in the neck muscles that move the vocal cords. You may be asked to make sounds to activate each muscle being tested. Information about nerve damage can clarify whether a vocal cord paralysis may recover, and provides information about voice changes stemming from neurological conditions such as ALS. EMG is also used for accurate Botox injections for spasmodic dysphonia.