Emory Voice Center Helps Patients Restore Damaged Voice with Injectable Gel

Damaged and paralyzed vocal cords can be restored with use of a natural filler, similar to collagen, that typically is used to plump lips or smooth wrinkles, say doctors at the Emory Voice Center at Emory Crawford Long Hospital.

At the Emory Voice Center, patients can walk into the office talking only in a whisper. After a short, in-office procedure many can leave with their normal voices intact once again.

Vocal cord paralysis is a voice disorder that occurs when one or both of the vocal cords do not open or close properly. It is a common disorder and symptoms can range from mild to life threatening.

The vocal cords are two elastic bands of muscle tissue located in the larynx (voice box) directly above the trachea (windpipe). When people speak or sing, the vocal cords vibrate together to produce sound. They remain open when a person is not speaking, allowing the person to breathe. And they close when people swallow to protect the airway.

"Damage to the nerves supplying the vocal cords is usually the result of spine, thyroid or chest surgery, or possibly a viral infection or a tumor," says Michael M. Johns, III, MD, director of the Emory Voice Center. "In fact, almost one in 10 patients we see has some sort of damage to the nerve leading to the vocal cords, resulting in vocal cord paralysis."

The nerve that supplies the vocal cords is the recurrent laryngeal nerve. This nerve winds from the voice box down to the chest and back up to the voice box, making it very susceptible to damage from surgeries, trauma and other illnesses.

People with certain neurological conditions such as Parkinson's disease, multiple sclerosis or stroke may also experience vocal cord paralysis.

To repair the damage and restore the voice, specialists inject a natural gel-like substance into the damaged or paralyzed vocal cord, which causes it to swell. The swelling helps the paralyzed vocal cord plump up and cause vibration and sound again. The injection takes 15 to 20 minutes and is performed in a doctor's office while the patient is awake. The patient actually participates in the procedure by talking and making sounds, as directed by the physician. A local anesthetic is used to numb the skin before the procedure begins.

"This procedure is minimally invasive, requires no trip to the operating room and is safe and very effective," says Johns, an assistant professor in the Department of Otolaryngology (ENT), Emory University School of Medicine. "In many cases, the damaged vocal cord will heal itself after trauma, so this injection is a great first option for temporary assistance while waiting to see if the vocal cord will recover."

The filler substance usually lasts from three to six months, depending on the degree of paralysis or damage. Most insurance companies do cover the in-office procedure.

Johns says some patients will need voice therapy to help them strengthen their voice after injury or damage, while others do not.

Johns and his partner, Adam Klein, MD, assistant professor in the Department of Otolaryngology at Emory, both perform the procedure. For more information or to schedule an appointment, please call Emory HealthConnection at 404-778-7777.