Voice disorders: hoarseness, vocal fold paralysis, and spasmodic dysphonia, per NIDCD
NIDCD says to see a doctor if hoarseness lasts “more than three weeks,” that people who use their voice for a living may be referred to a speech-language pathologist “for voice therapy,” and that an SLP is part of the team that evaluates vocal fold paralysis and spasmodic dysphonia. This page quotes three NIDCD fact sheets.
Quoted from official pages checked November 12, 2026. Confirm current information on those sites. This page is not medical advice and does not describe any patient’s care.
Sources read on November 12, 2026: NIDCD’s Hoarseness and Vocal Fold Paralysis pages (both last updated March 6, 2017) and its Spasmodic Dysphonia page (last updated June 18, 2020). These are older pages; check NIDCD for newer information.
Hoarseness
NIDCD states: “Hoarseness is often a symptom of problems in the vocal folds of the larynx.” And: “You should see your doctor if your voice has been hoarse for more than three weeks, especially if you haven't had a cold or the flu.”
On voice-heavy jobs: “Sometimes people whose jobs depend on their voices—such as teachers, singers, or public speakers—develop hoarseness that won't go away. If you use your voice for a living and you regularly experience hoarseness, your doctor might suggest seeing a speech-language pathologist for voice therapy. In voice therapy, you'll be given vocal exercises and tips for avoiding hoarseness by changing the ways in which you use your voice.”
Vocal fold paralysis
NIDCD states: “Vocal fold paralysis (also known as vocal cord paralysis) is a voice disorder that occurs when one or both of the vocal folds don't open or close properly.” It notes the airway risk: “You could have difficulty swallowing or food or liquids could accidentally enter the trachea and lungs, causing serious health problems.”
On diagnosis: “Vocal fold paralysis is usually diagnosed by an otolaryngologist—a doctor who specializes in ear, nose, and throat disorders.” On treatment: “The most common treatments for vocal fold paralysis are voice therapy and surgery.” NIDCD adds: “During this time, your doctor will likely refer you to a speech-language pathologist for voice therapy, which may involve exercises to strengthen the vocal folds or improve breath control while speaking.” And: “Surgery is followed by additional voice therapy to help fine-tune the voice.”
After a tracheotomy: “Following surgery, therapy with a speech-language pathologist helps you learn how to use the voice and how to properly care for the breathing tube.” And: “If you notice any unexplained voice changes or discomfort, you should consult an otolaryngologist or a speech-language pathologist for evaluation and possible treatment.”
Spasmodic dysphonia
NIDCD states: “Spasmodic dysphonia causes voice breaks during speaking and can make the voice sound tight, strained, or breathy.” It says diagnosis “usually follows examination by a team”, which includes an otolaryngologist, a neurologist, and “A speech-language pathologist, a health professional trained to evaluate and treat voice, speech, and language disorders. The speech-language pathologist will assess voice symptoms.”
On treatment: “Behavioral therapy (voice therapy) may reduce symptoms in mild cases. Voice therapy may work along with botulinum toxin injections to reduce voice strain.” NIDCD also says: “To date, there are no comparative studies pointing to a single, best treatment.”
What this page does not do
It does not describe surgical procedures or injections beyond the sentences quoted. It is not medical advice and does not recommend any treatment, medicine, or product. Scope of practice for each profession is set by state law; check your state board.