Treatment depends on the cause of the injury. In some instances, no treatment may be needed and the nerve may recover on its own. Voice therapy is useful in some cases.
If surgery is needed, the goal is to change the position of the paralyzed vocal cord to improve the voice. This can be done with:
Arytenoid adduction (stitches to move the vocal cord toward the middle of the airway)
Injections of collagen, Gelfoam, or another substance
If both the left and right nerves are damaged, a hole may need to be cut into the windpipe (tracheotomy) right away to allow breathing. This is followed by another surgery at a later date.
The outlook depends on the cause of the injury. In some cases, the nerve rapidly returns to normal. However, sometimes the damage is permanent.
Calling your health care provider
Call your health care provider if you have:
Difficulty breathing (call right away)
Unexplained hoarseness that lasts for more than 3 weeks
Lai SY, Mandel SJ, Weber RS. Management of thyroid neoplasms. In: Cummings CW, Flint PW, Haughey BH, et al., eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 124.
Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.