Vocal fold paralysis occurs when one or both of the vocal folds fails to move, limiting your ability speak. In some instances, vocal fold function returns on its own. In other cases, the paralysis is permanent.

Overview and Symptoms

Symptoms of vocal cord paralysis can include:

  • breathy of hoarse voice
  • noisy breathing
  • choking or coughing while swallowing food, drink or saliva
  • the need to take frequent breaths while speaking
  • inability to speak loudly
  • loss of your gag reflex

Laryngovideostroboscopy and speech evaluation determines whether voice therapy, surgical intervention or a wait-and-see approach is most appropriate.

During your first diagnostic visit, a speech pathologist will use a diagnostic tool called laryngovideostroboscopy to examine your vocal folds in slow motion.

On a second visit, a speech pathologist will collect acoustic measurements of your voice and have you participate in trial voice therapy techniques.


Voice therapy is much like physical therapy for any other part of the body. Sessions usually take place weekly for about 8 visits. You'll learn about the basic anatomy and physiology of the voice mechanism and about how to care for your voice. Pre-surgical counseling is provided when appropriate.

To achieve the best results, we'll provide exercises to be completed at home. We will do our best to help you figure out how to fit these practice exercises into your daily schedule.

Through practice, the body learns to make the small changes required for effective voice activation and for a smoother, easier voice. Regular practice helps to make these changes automatic so that eventually they come naturally. You may find it helpful to record your voice therapy visit using you smart phone or other recording device to aid with home practice.

If you need surgery, voice therapy may occur either before or after surgery takes place. After, you will have a final voice re-assessment and laryngovideostroboscopy.

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The Voice, Speech and Swallowing Therapy experts at BIDMC are nationally recognized leaders, specializing in the diagnosis and treatment of voice, airway, speech and swallowing conditions.

Voice, Speech and Swallowing Therapy