Save Your Voice

August 13, 2008 8:33:58 AM PDT
Vocal cord paralysis is a disorder that happens when one or both of the vocal cords (also called vocal folds) don't open or close properly. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), vocal cord paralysis is common, and symptoms can range from mild to life threatening. The vocal cords are two elastic bands of muscle tissue located in the voice box directly above the windpipe. The cords produce vocal sounds when air held in the lungs is released and passed through the closed vocal cords, causing them to vibrate. When a person is not speaking, the vocal cords remain apart to allow the person to breathe. Vocal cord paralysis has several causes. It could result after head trauma, a stroke, a neck injury, lung or thyroid cancer, a tumor pressing on a nerve, or a viral infection. People with certain neurologic conditions, such as multiple sclerosis or Parkinson's disease can also have vocal cord paralysis.

RESTORING THE VOICE: Sometimes, voice therapy is enough to restore the voice, but if that fails, there are other options. Researchers can restore the voice by adding "bulk" to the paralyzed vocal cord. To do this, an otolaryngologist injects a substance into the cord. That added bulk reduces the space between the vocal cords so the non-paralyzed cord can make closer contact with the paralyzed cord. Teflon and silicone are two substances that have been commonly used, but they can fail due to the poor response of the injection material to the body's immune system.

A BETTER FIX: Recently, Calcium Hydroxylapatite (CaHA) has been tried as an augmentation material to treat vocal cord disorders. CaHA is a major component of the mineral constituent for both bone and teeth and has been used in dental, orthopedic and head and neck bony reconstruction. It is a stable implant material with minimal inflammatory response and is not toxic. Researchers have used CaHA in a gel carrier to help restore the voice. The material is called Radiesse. In a prospective study of Radiesse for the treatment of vocal disorders, researchers found more than 80 percent of the patients have had significant relief in their symptoms to a near-normal voice. Radiesse is injected into the damaged vocal cord and as Roy Casiano, M.D., from the University of Miami says, "It's a space filler. It increases the bulk of the vocal cord where you have lost muscle." He says about 70 percent of the patients just need one injection. Another 20 percent need two injections and just 10 percent would need three or more injections.

Radiesse is commonly used to fill in wrinkles and to plump lips in the field of plastic surgery. Its use in vocal cord augmentation is a simple fix to a big problem. Dr. Casiano says being without a voice is a great stressor on one's quality of life. He says, "[Patients] are considerably desperate when they come in. They cannot go back to work because nobody understands them. The family does not understand them. They cannot even speak on the phone. It really impacts your social life. It's significantly debilitating."


Omar Montejo
University of Miami School of Medicine
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(305) 243-5654