ear, nose, and throat disorders
Vocal Cord Paralysis
Treatment of Vocal Cord Paralysis
Surgery If onlyone side is paralyzed,an operation can be done to move the paralyzed vocal cord to the best position for more normal speech. The operation may involve inserting an adjustable spacer near the paralyzed cord or injecting a substance into the paralyzed cord to move the cords closer together, improve the voice, and prevent aspiration. Whenboth sides are paralyzed,keeping the airway open adequately is difficult. A tracheotomy (surgery to create an opening into the trachea by cutting through the front of the neck) may be needed. The tracheotomy opening may be permanent or may be used only when the person has an upper respiratory tract infection. Sometimes reinnervation surgery (repairing the nerves to the vocal cords) can help with speaking, breathing, and swallowing. In another procedure, called an arytenoidectomy, the vocal cords are permanently separated, thus widening the airway. However, this procedure may worsen voice quality. Laser removal of part of one or both vocal cords is preferred to arytenoidectomy and helps widen the airway. If done correctly, laser removal can preserve satisfactory voice quality and eliminate the need for a tracheotomy. 