Laryngeal muscle weakness is defined as a weak voice, vocal leakage, singing out of tune, inability to sustain speech, and hoarseness if one speaks more than one word; examination reveals shortening of the vocal time, narrowing of the vocal range, bilateral retraction of the vocal folds, and incomplete closure. It is mostly seen in people with old age, kidney failure and overworked voice, mostly due to lack of vital energy and strain on the laryngeal muscle, unlike myasthenia gravis or neuropathetic diseases. Vocal fold closure insufficiency is a disease of vocalization, laryngeal muscle weakness causing hypermotility vocal fold movement disorder, also laryngeal muscle weakness and vocal fatigue. 1, inosine: energy metabolism activator, can enhance the laryngeal muscle energy metabolism, so that the strained laryngeal muscle repair. Take orally, 0.2~0.8mg each time, 3 times a day; inject intramuscularly, 0.2mg each time, 1 time a day. 2. Adenosine triphosphate (ATP): It is also an activator of energy metabolism. It is a coenzyme and has the effect of improving the metabolism of the body. It is a common drug for laryngeal muscle strain and laryngeal muscle weakness, and can treat progressive muscle atrophy and prevent laryngeal fibrosis in the elderly. Do skin test before injection. For intramuscular injection, 20mg each time (commonly used in water), 1~3 times a day; for intravenous injection, 20mg each time (commonly used in powder), dissolved in 500ml of 5%~10% glucose solution, 1~2 times a day. 3, mestinon (Ambecoxamine): a muscle excitatory drug, belongs to the class of anticholinesterase drugs. It can act directly on the cholinergic receptors of skeletal muscle cells, excite skeletal muscle and smooth muscle, enhance muscle tension, and improve muscle weakness. Take 2.5mg (half tablet) orally 3 times a day, or 5mg (one tablet) twice a day. 4. Neostigmine (Pristine): It is also a muscle excitatory drug, which can reversibly anticholinesterase and enhance the effect of acetylcholine, and can act directly on the motor end plate of skeletal muscle and act on the cholinergic receptors of skeletal muscle cells, with strong effect on skeletal muscle. Its excitation of skeletal muscle and smooth muscle, enhance the effect of muscle tension is stronger than mestinon, but the maintenance time is not as long as mestinon. Please refer to the doctor’s consultation for the specific medication.