The voice in a patient with Bilateral abductor paralysis of the larynx is

The vocal cord vibrates during speech to produce speech. These vibrations occur due to subglottic airflow when the cord is in adduction (Median & paramedian). During normal phonation the vocal cords are in median position and during strong whisper vocal cords are in paramedian position. So, for proper voice, the vocal cords should be in median or paramedian position. Same occurs in bilateral recurrent laryngeal nerve paralysis, where the vocal cords are in median or paramedian position → Voice is less likely to be impaired. Now, the question comes to the mind immediately : - Why the voice is affected in unilateral paralysis, in which the cord is in median or paramedian position. The answer is : - In unilateral vocal cord paralysis, one cord is paralysed and vibrates abnormally or does not vibrate at all, therefore cannot coordinate with the other side (normal) vocal cord. This results in voice problems. In bilateral paralysis, both vocal cords vibrate abnormally but coordinate with each other, therefore voice is less affected.