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Vocal fold insufficiency

When vocal cords cannot close completely, it is called vocal cord dysfunction, glottic insufficiency, or vocal fold insufficiency. Vocal fold insufficiency may be overlooked in a preliminary clinical evaluation1 in a patient with early or subtle vocal fold weakness where both vocal folds may appear mobile.

Vocal fold insufficiency is a common contributing factor in patients who present with dysphonia.1 A thorough exam, including visualization of the larynx, is essential to diagnose dysphonia caused by vocal fold insufficiency, especially in early stages.

Specific types of vocal fold insufficiency include1,2:

  • Paralysis of one or both* vocal folds due to:
    • Nerve injury
      • Iatrogenic—injury from intubation during surgery or surgical procedures themselves, such as thyroidectomy or cervical disc surgery
      • Trauma
    • Disease such as:
      • Tumors
      • Neurologic disorders such as Parkinson's disease—in fact, more than 70% of patients with Parkinson's disease experience dysphonia characterized by weak and breathy phonation and dysarthria3
  • Paresis (partial paralysis) of one or both* vocal folds
  • Vocal fold atrophy due to age, disease, or medications

*PROLARN GEL and PROLARYN PLUS are not indicated for paralysis of both vocal folds.

Which Patients Are Candidates for PROLARN GEL or PROLARYN PLUS?

Learn More

  1. Rosen CA, Simpson CB. Glottic insufficiency: Vocal fold paralysis, paresis, and atrophy. In: Operative Techniques in Laryngology. Heidelberg, Germany: Springer-Verlag; 2008.
  2. Giraldez-Rodriguez LA, Johns M. Glottal insufficiency with aspiration risk in dysphagia. Otolaryngol Head Neck Surg. 2013;46:1113-1121.
  3. Berke GS, Gerratt B, Kreiman J, Jackson K. Treatment of Parkinson hypophonia with percutaneous collagen augmentation. Laryngoscope. 1999;109:1295-1299.