Vocal cord paralysis (also referred to as “vocal fold” paralysis) is a condition in which the vocal cords cannot move on one side (unilateral) or both sides (bilateral). This is usually happens when the nerve impulses to the vocal cords are interrupted.
Vocal cord paralysis often causes one vocal cord to be unable to reach the other. When this happens, there is a gap between the vocal cords (glottic gap), which can impact your child’s ability to speak and even to breath.
Symptoms of vocal cord paralysis
Unilateral vocal fold paralysis may lead to:
Causes of vocal cord paralysis
- A breathy, weak voice
- A weak cry in babies
- Aspiration of liquids into the windpipe (trachea)
- Noisy breathing
Injury from heart surgery
is the most common cause of one-sided vocal cord paralysis. More rarely, a tumour along the length of the nerve to the voice box may lead to a paralysis. Sometimes, the cause of vocal cord paralysis is unknown (idiopathic).
Vocal cord paralysis is the second most common congenital defect of the larynx (voice box), accounting for about 10 to 15 percent of congenital laryngeal disorders.
Diagnosis of vocal cord paralysis
The diagnosis of vocal cord paralysis
is usually made by laryngoscopy or stroboscopy, tests that examine the voice box.
- Laryngoscopy: A doctor will place a spaghetti-like camera in your child’s nose and down the throat. This allows our team to look at your child’s voice box, or larynx.
- Stroboscopy: A small, thin, flexible endoscope with a camera is gently inserted through the nose to the area in the back of the throat above the vocal cords. The study evaluates the motion of your child’s vocal cords when there are concerns regarding the strength, pitch and quality of his voice.
A laryngeal electromyography (EMG) may also be needed to evaluate the condition of the muscle of the vocal cords. An EMG can also help your child’s doctors see if there is a healthy nerve signal to the vocal cords or if there is chronic loss of signal (denervation).
Magnetic Resonance Imaging (MRI) of the brain
, neck and chest may also be recommended if the cause of the vocal cord paralysis is not known.
Treatment of vocal cord paralysis
In most circumstances, your child may need no immediate treatment if she is diagnosed with one-sided vocal cord paralysis.
Some children may have improvement in their vocal cord movement over time, and some have improvement in the voice from compensation of the opposite vocal cord, where the vocal cords are able to contact one another. This improves the voice and swallowing and in most cases no further treatment is needed.
When there is no adequate compensation between the two vocal cords, surgical intervention
may be needed.
Prognosis of vocal cord paralysis
Some children with vocal cord paralysis will not have any related voice or swallowing issues and will have normal quality of life without treatment. However, in other children who do not undergo treatment for vocal cord paralysis, there is a significant impact on the ability to communicate: It may be hard to hear your child speak or to understand her due to a raspy or breathy-sounding voice.