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Vocal Fold Paralysis

What is it?

Vocal cords receive their signals through small nerves leaving the brain. Vocal cords are important for speaking but are also an important factor when breathing.
A vocal fold paresis or paralysis implies that the vocal folds move sluggishly or not at all.  This can occur on one or both sides resulting in a breathy and weak voice or, if both cords are affected, in breathing difficulties. 

Common causes are: viral infections and tumors located high in the neck, along the thyroid gland or in the chest. Injury can also occur accidentally during neck, chest or heart surgery. 

How is a vocal fold paralysis treated?

Not every paralyzed vocal fault requires treatment. However, if patients suffer from a breathy and soft voice or swallowing difficulties, any of the following therapies might be considered:

Vocal fold injection

A filler can be injected into the vocal fold to achieve a temporary bulking effect. These procedures are usually done in the office and within minutes, resulting in immediate voice improvement that may, depending on the filler used, last anywhere from several weeks to months. This is the preferred treatment option in cases where vocal fold recovery is possible but the approach may take more time to heal.


In cases with no chance for vocal fold recovery, open neck medialization thyroplasty (sometimes combined with a arytenoid adduction or arytenoid pexy) with insertion of a small implant to push the vocal fold in a more midline position is the preferred treatment option.  In contrast to the vocal fold injection, the open neck approach is permanent and needs to be done only once.   

To schedule an appointment, call 216-778-5791.

Our Doctors/Medical Providers

Mark S. Weidenbecher, MD

Mark S. Weidenbecher, MD


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