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Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

What Is It?

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:

  • Vocal cord nodules. These are small, hard, callus-like growths caused by vocal abuse. They occur in pairs, with one nodule on each vocal cord at the site of greatest irritation. They sometimes are called singer's, screamer's or teacher's nodules.

  • Vocal cord polyps. Polyps are small, soft growths that usually appear alone on a vocal cord. They are caused most often by vocal abuse or long-term exposure to irritants, such as chemical fumes or cigarette smoke.

  • Contact ulcers. This is a less common disorder. Contact ulcers are erosions and sores on the vocal cords. They tend to occur in people who consistently use great force when beginning to speak, instead of gradually increasing force and loudness. For example, contact ulcers may affect people who work as public speakers.

    Ulcers also can be caused by gastroesophageal reflux disease (GERD), or heartburn. Reflux is when acidic stomach contents flow back up the esophagus and irritate the larynx.

  • Laryngitis. Thisis a swelling of the vocal cords caused by inflammation or infection. Swollen vocal cords vibrate differently than usual, changing the typical sound of your voice. You can lose your voice if the inflammation is so severe that you can't make a sound.

Laryngitis can be caused by:

  • Vocal abuse

  • Allergies

  • Viral infection

  • Reflux of stomach acids

  • Exposure to irritating substances, such as cigarette smoke or too much alcohol

  • Vocal cord tumors. Tumors can be cancerous or noncancerous. Noncancerous tumors can be caused by a virus. Or they may be unusual growths of body tissue that cause voice problems. Cancerous tumors are most likely to occur in smokers and people who drink too much alcohol. Cancerous tumors are life threatening if not caught and treated early.

  • Vocal cord paresisand vocal cord paralysis. Vocal cord paresis occurs when one or both vocal cords don't open and close properly, changing voice quality. When one or both vocal cords don't move at all, this is called vocal cord paralysis. If both vocal cords are paralyzed and remain in the closed position, breathing can be difficult.

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

    • Surgical trauma, most often from thyroid surgery, but also from any neck or chest surgery

    • Head or neck trauma

    • Trauma during birth

    • A neurological disease (such as Parkinson's disease or multiple sclerosis)

    • Stroke

    • A tumor

    • A viral infection

    • Some debilitating diseases, such as myasthenia gravis

    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.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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