Vocal Fold Paralysis
What is vocal fold paralysis?
Vocal fold paralysis is a condition in which the vocal cords cannot move. It may affect one side (unilateral) or both sides (bilateral) of the vocal cords. This airway defect causes loud, noisy breathing when your child is active, but your child will probably be able to speak and cry normally.
What causes vocal cord paralysis?
Scarring from cardiac surgery is often the cause of one-sided vocal cord paralysis, but many times the cause is unknown. Two-sided vocal cord paralysis is often associated with birth trauma and central nervous system abnormalities (such as Chiari malformations or increased intracranial pressure). However, often a cause is not identified, and we say that the condition has an idiopathic etiology (unknown cause).
How common is vocal cord paralysis?
Vocal cord paralysis is the second most common congenital defect of the larynx (voice box). About 10 to 15 percent of congenital laryngeal disorders are vocal cord paralysis.
When does vocal cord paralysis occur and what are the symptoms?
Symptoms of vocal cord paralysis often show up by 2 months of age. Symptoms vary by the seriousness of the condition and may include:
Unilateral (one-sided) paralysis
- Aspiration
- Occasional stridor (noisy breathing)
- Weak, breathy cry
Bilateral (two-sided) paralysis
- High pitched, noisy breathing
- Blue spells
- Aspiration
- Shortness of breath with activity
How is vocal cord paralysis treated?
In most circumstances, no immediate treatment is needed for one-sided vocal cord paralysis. Treatment is needed when your child is having trouble breathing or is aspirating fluid into the lungs.
Treatment for unilateral (one-sided) vocal cord paralysis
If the only effect your child is experiencing from unilateral vocal cord paralysis is a weak, breathy, hoarse voice, we can perform procedures to make your child’s voice louder. At The Children's Hospital of Philadelphia, surgeons use two treatment approaches for single-sided paralysis:
- Injecting a filler material into the affected vocal cord
- Restoring function to the nerve for the vocal cord.
Treatment for bilateral (two-sided) vocal cord paralysis
Airway surgeons manage two-sided (bilateral) vocal cord paralysis by observation unless your child is having trouble breathing. When the airway is compromised, surgical options include:
- Tracheostomy tube placement
- Surgery to increase the opening in the back of the larynx (the posterior laryngeal airway).
Contact us
For more information about the conditions we treat or for help with airway problems, please contact us at 215-590-3440 and ask for the Airway Center coordinator.
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