Vocal fold paralysis or paresis - can speech therapy help?

Vocal fold paralysis or paresis is a common voice disorder and involves changes in the way one or both vocal folds move when producing sound (we have two of them). Ideally they should move symmetrically, close and open fully and vibrate in perfect harmony. So when you are given a diagnosis of a vocal fold paralysis or paresis, what does this mean? How can you get help? What does help look like?

To help you to understand this I'm going to list 5 facts about this voice disorder based on the most common questions I get in clinic. Hopefully they will also answer some of your questions too.

1) The difference between a vocal ford paralysis and paresis is as follows - with a paralysis one of both vocal folds are completely stuck in one position. This could be close to the midline or in an open position. A vocal fold paresis means that one or more vocal folds are not moving as they should but there is some movement there of the fold towards the midline.

2) Vocal fold paralysis or paresis can alter the sound of the voice. In fact, it normally does. This can vary from person to person depending on how the vocal folds are moving (or not). A distinguishable feature of this disorder is a breathy voice - lacking volume, strength, quality and pitch changes. This is because there is normally a gap between the folds.

3) Speech Therapy - or more precisely voice therapy - has a good success rate in treating voice in someone with a vocal fold paralysis or paresis. This means that the quality of the voice can sometimes be completely restored with therapy. Other times it’s therapy alongside other means and this will depend on the person.

4) Voice therapy sessions will follow on from an ENT assessment where they have had a good look at the vocal folds and how they are moving. This information will be used to plan assessment and therapy sessions. From my experience an average of five therapy sessions is needed - but off course this can vary.

5) Things you can do before you even begin therapy:

- Don't whisper and don't shout. Try to talk normally.

- Drink plenty of water and keep hydrated.

- Be patient with your voice and allow more breaks in your day for voice rest. Your voice is having to work harder to make sound and may tire more easily. You don't want to over work it as this may cause more damage.

- If you get breathless pace yourself by going a bit slower for example when going up the stairs. Depending on where the vocal fold is positioned your airway may be smaller.

- It might be tempting but try to avoid clearing your throat - again this could be more damaging.

So there you have it - vocal fold paralysis or paresis is definitely something a voice therapist can help with and there is always hope. It's worth the time to look into it and to do the work to try to improve the voice with the right treatment.

Here at VC Speech Therapy we offer virtual consultations and therapy for people with a voice disorder. Have a look at our services page here or contact us on info@vcspeechtherapy.com for more information.