What is VFP?

Vocal cords (or vocal folds) are multi-taskers, performing several vital jobs. In the closed position, these pearl-colored, elastic bands of muscle tissue allow us to speak or sing by vibrating when air is pushed through them. They also form a barrier at the top of the windpipe, or trachea, preventing food or liquid from entering the lungs. In the open position, vocal cords allow air to pass easily in and out of the lungs.

The cords get their instructions via the laryngeal nerves. The recurrent laryngeal nerves run from the brain all the way to the heart. (When someone says they’re “speaking from the heart”, it’s the anatomical truth.) When the system is working properly, we speak, breathe and swallow with little effort.

If either, or both, of the recurrent or superior laryngeal nerves are damaged, the vocal cords can no longer receive neurological signals from the brain. The affected cord or cords hang limply above the trachea, unable to open or close. Someone with vocal fold paralysis may speak in a breathy or hoarse voice and may choke easily on food or liquid. They may have difficulty breathing. The symptoms of paralysis can range from mildly annoying to life-threatening.

What causes the damage? Certain medical procedures; such as heart or thyroid surgery, endoscopy, or intubation frequently cause vocal fold paralysis. Neurological conditions such as Parkinson’s disease, Multiple Sclerosis, or stroke can cause it, as can tumors, cancers, goiters, or trauma to the neck or throat. Paralysis can even occur with age, as the cords become thinner and less responsive.

Most people who acquire vocal fold paralysis as a result of surgery or trauma recover, usually within a few months. Some, however, never regain nerve function.

People with permanent vocal fold paralysis have a serious disability, but they also have treatment options. Therapy with a good speech pathologist can offer techniques to help maximize whatever function remains. Medialization through surgery or injection can bring the vocal folds closer together, allowing them to vibrate more normally during speech. Relaxation techniques, massage therapy, and acupuncture sometimes help ease the strain of speaking. No treatment can magically restore the voice, but the right combination of therapies and surgery can significantly improve quality of life.

For more information, click on the links below:

The New York University Voice Center

National Institute on Deafness and Other Communation Disorders

The American Speech-Language-Hearing Association

Center for Voice and Swallowing at University of California Davis Health Center

A collection of videos of both healthy and damaged vocal cords, provided by James P.Thomas, MD

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