In a tracheotomy, an incision is made in the front of your neck to create an opening in the windpipe (trachea). This causes a lot of trouble breathing and requires a surgery called a tracheotomy. If both of your vocal cords are paralyzed and positioned closely together, your airflow will be decreased. Some health care providers combine this surgery with a bulk injection. It can take as long as 6 to 9 months before your voice gets better. In this surgery, a healthy nerve is moved from a different area of the neck to replace the damaged vocal cord. Replacing the damaged nerve (reinnervation).This allows your unimpaired vocal cord to better vibrate against its paralyzed partner. In this procedure, a surgeon moves a window of your own tissue from the outside of your voice box inward, pushing the paralyzed vocal cord toward the middle of your voice box. Rarely, people who have this surgery may need to have a second surgery to reposition the implant. Instead of using a bulk injection, this procedure - known as thyroplasty, medialization laryngoplasty or laryngeal framework surgery - relies on the use of an implant in the larynx to reposition the vocal cord. This added bulk brings the affected vocal cord closer to the middle of your voice box so that the opposite functioning and moving vocal cord can make closer contact with the paralyzed cord when you speak, swallow or cough. To add bulk to a paralyzed vocal cord, a doctor who specializes in disorders of the larynx (laryngologist) may inject your vocal cord with a substance such as body fat, collagen or another approved filler substance. Paralysis of the nerve to your vocal cord will probably leave the vocal cord muscle thin and weak. If your vocal cord paralysis symptoms don't fully recover on their own, surgical treatments may be offered to improve your ability to speak and to swallow. Occasionally, voice therapy may be the only treatment you need if your vocal cords were paralyzed in a location that doesn't require additional bulk or repositioning.
Voice therapy sessions involve exercises or other activities to strengthen your vocal cords, improve breath control during speech, prevent tension in other muscles around the paralyzed vocal cord or cords, and protect your airway during swallowing. However, surgical treatment with various bulk injections is often done within the first three months of voice loss.ĭuring the waiting period for surgery, your provider may suggest voice therapy to help keep you from using your voice improperly while the nerves heal. For this reason, your health care provider may delay permanent surgery for at least a year from the beginning of your vocal cord paralysis. In some instances, you may get better without surgical treatment. Treatment may include voice therapy, bulk injections, surgery or a combination of treatments. Treatment of vocal cord paralysis depends on the cause, the severity of symptoms and the time from the onset of symptoms.
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