BOTOX Treatment for Vocal Cord (left) Paralysis?

A procedure to augment and/or medialize the paralyzed vocal fold would be indicated to improve the 81 year old man's speech.  Botox has no role in treating vocal fold paralysis.  A board-certified laryngologist would be best equipped to address your concerns.     

A paralyzed vocal cord is best treated with an implant to move the vocal cord more medially or with a long term filler like Radiesse.  Injecting Botox into the vocal cord would make the voice worse, not better, for someone with paralysis.  One of the original indications for Radiesse was placement in the vocal cord for someone with paralysis.  Spasmodic dysphonia is when the vocal cords are too tense from spasm and Botox relaxes the muscles so they can speak near normal.  This was one of the first indications for Botox as well.