The treatment of vocal chord paralysis depends upon the cause of the paralysus, severity of the symptoms and the time from the onset of the symptoms. Treatment includes voice therapy, surgery or both. Voice therapy is often the first treatment option. Even when nothing can be done to heal nerve damage that can cause the paralysis, the function of the larynx can improve. This can be done by a speech therapist . If surgical treatment is necessary, it includes bulk injection, medialization thyroplasty or tracheotomy. There might be differences in the voice after the surgery, but these can be improved by speech therapy.