Vocal Cord Paralysis – Symptoms and Causes
Overview
Vocal cord paralysis occurs when the nerves controlling the vocal cords become damaged or stop working properly.
The vocal cords, also called vocal folds, not only produce sound but also help protect the airway during swallowing by closing tightly to prevent food or liquids from entering the lungs.
This condition may affect one or both vocal cords, with varying impacts on voice, breathing, and swallowing. The severity depends on the extent of the nerve damage and whether one or both sides are involved.
Signs of Vocal Cord Paralysis
Vocal cord paralysis happens when you lose control of one or both vocal cords. Most cases affect just one cord, while paralysis of both cords is less common but more serious.
Your vocal cords are muscle bands that sit at the entrance of your windpipe. They come together to make sounds when you speak and stay open when you breathe.
If you have vocal cord paralysis, you might notice:
- Breathy, hoarse voice
- Noisy breathing
- Trouble catching your breath
- Changes in voice pitch
- Coughing or choking when eating or drinking
- Need to pause for breath while talking
- Difficulty speaking loudly
- Reduced gag reflex
- Weak cough
- Constant throat clearing
When You Should Get Medical Help
See your healthcare provider if you have unexplained hoarseness lasting more than 2-4 weeks.
Don’t delay seeking medical attention if you notice any changes in your voice or feel discomfort in your throat area. Early diagnosis can lead to more effective treatment options.
Causes
Vocal cord paralysis occurs when nerve signals to the larynx (voice box) are disrupted, leaving the muscles unable to move properly. Many cases have no clear cause, but several known factors can trigger this condition.
| Common Causes | Description |
|---|---|
| Surgical complications | Nerve damage during neck or chest procedures |
| Viral infections | Certain viruses that affect the laryngeal nerves |
| Cancer | Tumors that press on or damage the nerves |
Surgical procedures near the neck or upper chest area pose significant risks. Operations on the thyroid, parathyroid glands, esophagus, neck, or chest can accidentally damage the nerves that control vocal cord function.
Physical trauma plays a major role in some cases. Direct injuries to the neck or chest region may harm either the nerves serving the vocal cords or damage the voice box itself.
Medical conditions that can cause vocal cord paralysis:
- Stroke (disrupts blood flow to brain areas controlling voice)
- Tumors (both benign and malignant) pressing on nerves or muscles
- Infections (including Lyme disease, Epstein-Barr virus, herpes, and possibly COVID-19)
- Neurological disorders (such as multiple sclerosis and Parkinson’s disease)
Voice changes often provide the first indication something is wrong. Some cases resolve over time as nerves heal. Others may result in long-term voice or breathing issues that require treatment.
What Increases Your Risk
People who have surgery on their throat, thyroid, or upper chest face a higher risk of vocal cord nerve damage. During these procedures, the nerves controlling the vocal cords may get injured.
Breathing tubes used during surgery or for respiratory support can also harm these nerves.
Those with neurological disorders have greater chances of developing vocal cord weakness or paralysis. Conditions like Parkinson’s disease and multiple sclerosis often affect nerve function throughout the body, including the nerves that control vocal cord movement.
Complications
Vocal cord paralysis can cause different levels of breathing issues. Some people may only have a hoarse voice, while others might face more serious problems.
When vocal cords don’t work properly, the airway can’t fully open or close. This creates a risk of food or liquid entering the lungs, called aspiration.
People with this condition might choke on what they eat or drink. Though rare, severe aspiration can lead to pneumonia, which is a serious medical emergency requiring immediate treatment.
