Vocal Fold Paralysis

Vocal cords, also known as vocal folds, are part of our sound creating process. The vocal cords sit on top of the windpipe. When air is pushed through the lungs it passes between the open vocal cards, causing them to vibrate. This creates a buzzing sound. The buzzing is then passed through the throat, nose and mouth where it is changed into speech. If something happens to the vocal cords, such as paralysis, your voice will change. This often results in hoarseness or an inability to speak loudly.


Woman with hand on throat - vocal fold paralysis | Sacramento ENT
Vocal cord paralysis occurs when the nerve impulses to your voice box are disrupted. There are a number of possible causes of this condition, including:

  • Stroke.
  • Tumors.
  • Viral Infection.
  • Neurological Condition.
  • Neck or Cheek Injury.
  • Injury During Surgery.

Vocal cord paralysis can be bilateral or unilateral. Bilateral paralysis means both cords become stuck half open and half closed, and the cords are unable to move in either direction. Unilateral paralysis occurs when only one side is stuck or has very limited movement.


Hoarseness, an inability to speak loudly and choking or coughing while eating are common signs of vocal cord paralysis. To make a diagnosis, your doctor will review your symptoms and complete a physical exam. An endoscope will be inserted down your nose or throat so your doctor can get a better look at your vocal cords. Once the vocal cords are in view, your doctor will ask you to speak in order to watch what happens.


If you are diagnosed with bilateral vocal cord paralysis, a tracheotomy may be needed. This procedure creates a hole in your trachea, and a tube is inserted to help you breathe. Unilateral vocal cord paralysis may also require surgery to move the paralyzed vocal cord.

Non-surgical treatments such as behavioral therapy may be recommended by your doctor before surgery is needed. This type of therapy will teach you how to breathe better and how to find the best body positon for you to produce strong speech.

Contact Sacramento Ear, Nose & Throat for more information or to schedule an appointment.