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Pediatric Vocal Cord Paralysis

About Pediatric Vocal Cord Paralysis

Vocal cord paralysis (VCP) occurs when one or both vocal cords are unable to move properly. This condition can affect a child’s ability to breathe, speak, and swallow. VCP is categorized into two main types based on the number of vocal cords affected:

  • Unilateral Vocal Cord Paralysis (UVCP): Only one vocal cord is affected.
  • Bilateral Vocal Cord Paralysis (BVCP): Both vocal cords are affected.

Normal Vocal Cord Function

The vocal cords play several critical roles:

  • Voice Production: They vibrate to produce sound for speaking and crying.
  • Airway Protection: They close during swallowing to prevent food and liquid from entering the lungs.
  • Breathing Regulation: They help control airflow during breathing and coughing.

When the vocal cords cannot move properly due to paralysis, these functions may be compromised, leading to breathing difficulties, swallowing problems, and changes in voice.

Causes of Vocal Cord Paralysis

Vocal cord paralysis can be caused by various factors:

  • Congenital: Present at birth, often due to nerve or brain abnormalities such as Chiari malformations.
  • Acquired: Causes include trauma during birth, head or neck injuries, surgeries (e.g., heart or chest surgeries), infections, or prolonged intubation.
  • Idiopathic: In some cases, the cause remains unknown.

Symptoms of Vocal Cord Paralysis

The symptoms depend on whether one or both vocal cords are affected:

Unilateral Vocal Cord Paralysis (UVCP)

  • Weak or breathy voice
  • Coughing or choking during feeding, especially with liquids
  • Recurrent respiratory infections due to aspiration

Bilateral Vocal Cord Paralysis (BVCP)

  • Noisy breathing (stridor), especially during crying or exertion
  • Difficulty breathing, which may lead to pauses or turning blue
  • Frequent pneumonias due to aspiration
  • Choking or coughing during feedings

Diagnosis of Vocal Cord Paralysis

Diagnosing VCP involves careful evaluation using specialized tools:

  • Flexible Laryngoscopy: A small camera is inserted through the nose to examine the vocal cords and assess their movement.
  • Microlaryngoscopy and Bronchoscopy (MLB): Performed under anesthesia to examine the airway and detect structural abnormalities.
  • Imaging Studies: MRI or CT scans may be used to identify underlying causes such as nerve compression or abnormalities.

Treatment for Vocal Cord Paralysis

Treatment options depend on the severity and type of paralysis:

  • Observation: In some cases, especially UVCP, the condition may improve on its own within 12-24 months.
  • Surgical Interventions:
    • Vocal Cord Injection: Temporarily strengthens the paralyzed vocal cord to improve voice and swallowing.
    • Airway Expansion Surgery: For BVCP, procedures such as widening the airway or tracheostomy may be required to maintain a safe airway.
    • Nerve Grafting: Restores nerve function to improve vocal cord movement.
  • Speech and Swallowing Therapy: Helps improve voice quality and swallowing safety.

When to Seek Immediate Help

Contact a doctor or call 911 if your child:

  • Has difficulty breathing or turns blue
  • Chokes or coughs frequently during feeding
  • Struggles to gain weight or shows signs of aspiration

Why Choose Rady Children’s Hospital?

At the Center for Pediatric Aerodigestive Disorders and Airway Surgery, we provide expert care for vocal cord paralysis, including:

  • A multidisciplinary team of otolaryngologists, pulmonologists, gastroenterologists, and speech-language pathologists.
  • State-of-the-art diagnostic and surgical techniques tailored to your child’s needs.
  • Comprehensive care plans that focus on improving breathing, swallowing, and voice function.
  • Family-centered support to guide you through every step of diagnosis, treatment, and recovery.

Contact Us

If your child has been diagnosed with vocal cord paralysis or has symptoms of the condition, our team is here to help. Schedule a consultation to learn more about treatment options and personalized care plans.

Request Appointment