Vocal cord paralysis - Vocal fold immobility (1525)

What are vocal cords? 

Vocal cords (folds) are two muscles in the throat. They are in the voice box (larynx) at the top of the windpipe. They have 3 important jobs: 

1.When we breathe, they open to let air get through the windpipe to the lungs.
2.When we talk, they close and vibrate against each other to make sound.
3.When we swallow, they close to help protect the windpipe.   

What is vocal cord paralysis?

Vocal cord paralysis, or vocal fold immobility, means one or both vocal cords are not moving like they should. There are nerves that make the vocal cords move. When these nerves are injured, this can affect how the cords move. Injury to the nerves can come from:

• Surgery in the neck or chest. 
• Brain or nerve conditions. 
• Trauma. 
• Viral infections.

Sometimes the reason for the vocal cord paralysis is not known. 

How is it diagnosed?

Medicine may be sprayed in your child’s nose and down the back of their throat. A small camera is then passed through the nose.  The doctor looks at where your child’s vocal cords are to see if they move. This test was done, and found that:

Your child’s vocal cord paralysis is on the:

• Left side
• Right side
• Both sides

The cord(s) is stuck in:

• The middle. This is called Midline position. 
• Between the middle and sides. This is called Paramedian position. 
• Off to one side. This is called Lateral position.

How will it affect my child? 

Your child may have:

• Breathing problems.
• Trouble with swallowing or choking.
• A weak, hoarse, cry or voice. 

It does not affect language development. 

Will it get better?

• About 1 of 4 kids gets better.  If they do, it is most often within 6 months. 
• Some will adjust their symptoms even if the paralysis does not go away. 
• Most will still have symptoms from their vocal cord paralysis.

How will it be managed?

• Most kids will not need surgery. 
• Some will need to have surgery soon after getting diagnosed. This may be needed to help them breathe or eat better. 
• Surgery or voice therapy may be needed in the future. Because of this, we recommend follow-up in our clinic 1 month after diagnosis, and then every 4 months for the first year. It is very important to bring your child for follow-up.
  Depending on your child’s symptoms, we may pass a camera through the nose again to see the voice box and make sure the vocal cords are moving well. If your child continues to have problems, we recommend yearly follow-up after the first year. 

Your child’s pediatric otolaryngologist is Dr. ___________________________. 
Office phone: 414-266-________.
Your child’s speech pathologist is ______________________________.
Office phone: 414-266-________.