Vocal cord paralysis can occur when either one fold (unilateral) or both folds (bilateral) stop working. When one of the vocal folds no longer works, you may notice a change in your voice quality, ability to swallow, and even possibly feeling short of breath. When both folds aren’t working, patients may notice significant changes to their breathing, swallowing or voicing, and sometimes need immediate surgical intervention depending on the position of the immobile cords.
Vocal cord immobility, where one vocal cord is no longer working at full capacity, can happen even randomly after a mild upper respiratory illness, such as the flu. While most vocal cord paralysis occurs from 1) nerve injury sustained during a surgery, 2) pressure on the nerve from a tumor growing next to it, or 3) inflammation, you don’t need to have undergone surgery or an intubation to have a vocal cord injury. Additionally, bilateral vocal cord paralysis can also happen due to neurological diseases like stroke, as well as certain drug side effects. In some cases, the vocal cords can stop working from an unknown cause, and this is called idiopathic vocal cord paralysis.
Unlike other types of voice disorders, vocal cord paralysis doesn’t just resolve with voice rest or medication, although voice therapy is often recommended as part of the treatment plan. Some cases of vocal cord paralysis will recover on their own, while others may require other treatments or surgery.
Depending on the type of paralysis, the initial treatment plan may involve voice therapy to help restore voice function. Sometimes a minor surgical procedure is merited to help the voice, and possibly improve breathing and/or swallowing, while we wait to see how the nerve that moves the vocal cord does over time.