Treatments for vocal cord paralysis center on voice therapy and surgery. Many times the vocal cords recover naturally within the first year of diagnosis, so the doctor may advise postponing surgery to allow the body time to heal. A speech pathologist can provide therapy to strengthen the vocal cords, improve breath control when speaking and how to use the voice to compensate for the damage.
In general, surgical treatment options for vocal cord paralysis reposition the vocal fold muscle. Procedures include using stitches (arytenoids adduction) to move the folds closer together. Medialization laryngoplasty, also called thyroplasty or laryngeal framework surgery, inserts a structural implant to move the vocal fold. Both methods tend to produce a stronger voice and follow-up speech therapy helps the patient gain more control of speech.
In the event both vocal cords become paralyzed, a tracheotomy may be necessary to insert a tube into the windpipe to restore the ability to breathe. The patient now inhales and exhales through the opening in the trachea, called the stoma. Follow-up therapy by a speech language pathologist helps the patient learn how to speak and care for the breathing tube.
Once stabilized, procedures such as partial cordotomy or arytenoidectomy (to open up the airway) can be performed to help the patient breath and to get the tracheostomy removed.