Hyaluronic acid is a naturally occurring gel-like substance that can be injected into the vocal folds to treat vocal fold atrophy (thinning), paresis (weakness), or paralysis. These conditions can lead to a breathy or weak voice, difficulty projecting, or vocal fatigue. The injection aims to bulk up the vocal fold, improve closure, and restore a stronger, more efficient voice.

This procedure is done in the office using a flexible scope and local anesthesia. The vocal fold is visualized with a camera, and a fine needle injects hyaluronic acid through the mouth or neck. The injection takes about 15–20 minutes. Some patients may feel a brief pinch, fullness, or urge to cough, but the procedure is usually well tolerated. You may be advised to rest your voice for a day, but normal speaking usually resumes quickly. The improvement is often immediate or noticed within a few days. Results typically last 3–6 months, though some patients experience more extended benefits. For long-term results, repeat injections or fat transfer may be considered. Risks are minimal and include temporary hoarseness or instability in the voice as the material settles.