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Vocal Cord Disorders

Medically reviewed by Last updated on Jan 22, 2024.

What Is It?

Harvard Health Publishing

The vocal cords are two bands of elastic muscle tissue. They are located side by side in the voice box (larynx) just above the windpipe (trachea). Like other tissues in the body, vocal cords can be strained and damaged. Vocal cords are also subject to infections, tumors and trauma. 

When you are silent, the cords remain open. They create an airway through which you breathe.  

When you speak, the air you exhale from your lungs is forced through the closed vocal cords. This causes them to vibrate. They vibrate faster for higher-pitched sounds, slower for lower-pitched sounds. 

Strained vocal cords generally aren't noticed until the problem becomes severe. People who use their voices for a living or who shout or scream frequently are at particular risk. People who work in noisy environments that require shouting to communicate are also at risk.  

Common vocal cord disorders include:  

Laryngitis can be caused by:

Vocal cord paresis and paralysis can have several causes, including:

Paresis also can result from weakened vocal cord muscles. Vocal cord muscles can be weakened temporarily as a side effect of inhaled corticosteroid medicine sprays. They may also weaken after extended treatment with an artificial respirator (ventilator) in a hospital. 


Symptoms can vary, depending on the vocal cord disorder.


Your doctor will ask about your medical history. The doctor will listen to the quality of your voice and then inspect your vocal cords. This is usually done by holding a small mirror at the back of your mouth. To get a better view, the doctor may use a small, flexible lighted tube with a camera at the end. The tube is inserted through the nose to the larynx. 

You will need to make certain sounds so your doctor can see your vocal cords in action. The examination may be videotaped so your doctor can analyze it later. This is all that is needed to diagnose most cases of laryngitis, vocal cord nodules and polyps. 

In some cases, your doctor may recommend an acoustic analysis. This is a series of tests that measure the quality of your voice, including its pitch stability, range and intensity. Often, these tests are used when vocal cords are paralyzed or if a growth must be removed surgically. Using the test results, doctors and voice therapists can judge the amount of improvement after treatment.  

Cancer of the larynx can look similar to a noncancerous growth or a contact ulcer. If an abnormality is found on the vocal cords, your doctor may do a biopsy. A biopsy involves removing a tiny sample of the affected vocal cord tissue so it can be examined in a laboratory.  

Additional tests, such as a computed tomography (CT) scan or MRI, may be required in some cases.  

Expected Duration


To help prevent disorders caused by vocal abuse (including laryngitis, vocal cord nodes and polyps, and contact ulcers), you need to learn how to talk without straining your vocal cords. A voice therapist can teach you how to do this. Look for a licensed and certified speech-language pathologist who specializes in voice. 

To prevent disorders related to acid reflux (including contact ulcers and laryngitis), see your doctor to treat the reflux. Medications can help to control stomach acid. Lifestyle changes also help some people. Changes include:  

To help prevent vocal cord disorders caused by irritation (including laryngitis and vocal cord polyps), avoid smoking, drinking or inhaling chemical irritants. To help prevent vocal cord cancer, quit smoking and limit your consumption of alcoholic beverages.  

If you use an inhaled corticosteroid medicine to treat asthma or other lung disease, you may be able to prevent vocal cord muscle weakness. Use a spacer device that catches large medicine droplets too heavy to be carried deep into your lung airways. These large droplets can otherwise settle in your throat and trachea, where they can cause side effects. 

If you have viral laryngitis, cover your mouth when coughing and wash your hands often to prevent others from getting your infection. 


For vocal cord disorders resulting from vocal abuse, there are two main treatments:  

If rest and therapy don't resolve the disorder, other treatments are available. They are based on the type of disorder:

Treating cancerous tumors depends on the extent of the cancer. In the early stages, radiation, chemotherapy, surgery to remove a portion of the larynx or a combination of treatments may be needed. Some voice will remain after these procedures.  

In later stages of cancer, the entire larynx, including the vocal cords, must be removed (laryngectomy). You will need to learn a new speech method, using a special valve inserted surgically between the trachea and the esophagus. This allows air to be sent up the esophagus, creating enough vibrations for understandable speech.  

If improvement is not satisfactory, surgery may be recommended to change the position of the affected vocal cord. Surgery can also add bulk by injecting the vocal cord with collagen, body fat or some other substance.  

These types of procedures are recommended more often when one of the vocal cords is paralyzed. Both techniques bring the paralyzed cord closer to the cord that is not paralyzed. This allows the cords to vibrate enough to make sounds.  

For people with two paralyzed vocal cords, the goal of treatment is to improve breathing. The most common procedure is a tracheotomy. This procedure creates a hole in the neck below the level of the vocal cords. A breathing tube is placed into the hole.  

When To Call a Professional

See your doctor if you:


Cancerous tumors can be very serious. The earlier they are detected and treated, the better the likelihood of survival and cure. Your voice may change dramatically, depending upon the extent of the cancer and the type of treatment.

Additional Info

National Institute on Deafness and Other Communication Disorders
National Institutes of Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.