The vocal folds are paired structures in our throat that open to allow us to breathe and close to vibrate to produce our voice. Sometimes when people lose their voice, often acutely, it can be due to a virus after a cold, it can be due to intubation from surgery, neck trauma, or neck surgery, that can injure the nerve called the recurrent laryngeal nerve, which allows the vocal folds to move. If that nerve is injured, that vocal fold can become weak or even paralyzed, which could result in a very breathy voice with a harsh quality, loss of air, that can lead to substantial loss of voice, fatigue, vocal fatigue, and difficulty communicating. More worrisome is food and liquid can travel through the vocal cords into the lungs and lead to pneumonia because the vocal folds are the safety fel that protects the windpipe from having food or liquid enter into the lungs. If you have a breathy voice with vocal fatigue, need significant effort to speak, have a constant cough, and these symptoms have begun, especially after an upper respiratory infection intubation for any type of surgery, neck surgery, possibly from lung disease, such as a lung tumor, you might have a vocal cord that is paralyzed or weak. I've been caring for patients with vocal fold weakness and vocal fold paralysis for nearly 20 years and have introduced many of the techniques to rehabilitate these problems in the Hudson Valley region. Most important is diagnosis of this problem, which can be done with specialized equipment and the experience and knowledge to interpret these findings. Once diagnosed, treatment can range from voice therapy specifically geared towards the findings that we arrive at. And if voice therapy is not sufficient, there are numerous procedures that I can do, whether it be in the office setting with injection laryngoplasty or in the operating room with an open thyroplasty technique. These techniques are geared towards moving the weakened or paralyzed vocal cord into the middle of the voice box to allow the functional side to meet in the midline, which then produces excellent vocal quality and can improve cough. If you have a known vocal cord that is weak or paralyzed, or if you have persistent coarseness after having had surgery, an upper respiratory infection, you're a smoker, or have a known lung tumor, I can see you in consultation to provide a complete and thorough evaluation, arrive at a diagnosis and a treatment regimen that is best for you to help rehabilitate your voice, help protect your airway and provide a much better quality of life.