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Vocal Cord Surgery Vocal Cord Paralysis The vocal cords are two elastic bands of tissue in the voice box (larynx). Normally, they stay in an relaxed (apart) position for air to pass from the mouth to the lungs. When a person speaks, the vocal cords tighten, close, and vibrate as air passes between them. Pitch and volume of the sound is controlled by the tension of the cords. Speech is produced when the sounds are modified by the tongue, palate and lips. In vocal cord paralysis, one or both of the vocal cords is unable to open and close properly. This causes changes in voice quality, hoarseness, and discomfort (from strained vocal cords). Patients may also experience coughing, swallowing problems, or breathing problems. Vocal cord paralysis occurs when there is pressure or injury to the nerves that move the cords. It can be caused by viral infection, head injury, stroke, lung or thyroid cancer, or neurologic diseases (such as multiple sclerosis or Parkinson's disease). Treating Vocal Cord Paralysis Some people with vocal cord paralysis eventually recover. Therapists can teach the patient exercises to strengthen the vocal cords, improve breath control during speech or learn to speak more clearly. If therapy doesn't help, surgery may be needed. In one type of procedure, a material such as Teflon(r) or collagen is injected through the side of the neck. This adds bulk to the vocal cord, reducing the space between the cords and improving voice quality. When these treatments fail, surgery may be performed to permanently change the position of the paralyzed cord. Some physicians are now using a material called hydroxyapatite for patients with paralyzed vocal cords. It's surgically implanted into the paralyzed cord while the patient is under local anesthesia. During the procedure, the patient performs vocal exercises. The physician can fine-tune voice quality by changing the size or position of the implant. Like other types of fillers, hydroxyapatite closes the gap between the cords so the cords can vibrate more effectively. But the material is more compatible with human tissue and eventually becomes a permanent part of the body. SOURCES: written requests for information ONLY. Ahmed Soliman, M.D. (featured in story), Director, Laryngology and Voice Center, Temple University, Office of Public Relations, Health Sciences Center, 3400 North Broad Street, Philadelphia, PA 19140 AUDIENCE INQUIRY For general information on voice problems or vocal cord paralysis: American Speech-Language-Hearing Association -- http://www.asha.org/consumers/brochures/voice.htm National Institute on Deafness and Other Communication Disorders -- http://www.nih.gov/nidcd/health/pubs_vsl/vocalparal.htm