Vocal Cord Paralysis

Vocal cord paralysis [puh-RAL-uh-sis] happens when your child can’t move their vocal cords. The vocal cords are muscles that are flexible. The edges of these muscles vibrate to make the sounds your child uses to talk. They are found in the larynx [LAR-ingks] (or voice box) above the trachea [TREY-kee-uh] (or windpipe).

The vocal cords also play a role in helping your child breathe and swallow. When your child breathes, the vocal cords need to be open. When your child swallows, the vocal cords need to close so food and drink do not go down the windpipe, where they might get into the lungs.

Having one paralyzed vocal cord is far more common than two. Usually, the hurt vocal cord stays slightly open, which increases your child’s risk of choking. Paralysis of both vocal cords is rare. When both vocal cords can’t move, it can be dangerous. Your child might not be able to breathe.

The cause of vocal cord paralysis is often not known. It can be caused by nerve damage, brain disorders, injury, infections, or tumors.

This condition may also be called by these names:

• Vocal cord paresis [puh-REE-sis] (when only one cord can’t move)
• Vocal fold paralysis (a vocal fold is another name for a vocal cord)
• Vocal cord palsy [PAWL-see ] (palsy is another name for paralysis)

Your child’s symptoms may be mild or severe, depending on how much paralysis they have. The symptoms of vocal cord paralysis include some or all of these:

• Being hoarse
• Having a breathy voice
• Not being able to speak loudly
• Not being able to control pitch
• Noisy breathing
• Being short of breath
• Coughing or choking

When food, drink, or spit gets past the vocal cords and into the lungs, it can cause problems such as pneumonia [noo-MOHN-yuh]. When both vocal cords can’t move, it can be very hard to breathe.

Most boys have voice changes in their teens, and kids who have colds might be hoarse. But if you can’t tell why your child’s voice changes or if it hurts when they try to talk, you should check with a healthcare provider.

Vocal cord paralysis happens when one or both of the vocal cords cannot move. The cause of vocal cord paralysis is usually not known. In some cases, the condition can be caused by:

• Injuries to the head, neck, and chest
• Cancer in the lungs or thyroid
• Tumors at the bottom of the skull or in the neck or chest
• Infections such as Lyme disease

Sometimes, a condition in the brain can cause it. Though rare in kids, it can be caused by Parkinson’s disease, multiple sclerosis [skluhr-OH-sis], or having a stroke.

A healthcare provider will ask about your child’s symptoms, including when they started, and listen to your child speak. They might order an MRI or CT scan.

During an exam, your child’s healthcare provider may use an endoscope, which is a tube with a light and a camera at one end. With it, they will look down your child’s throat and watch how the vocal cords move as your child breathes and tries to make sounds.

A specialist called an ENT (ear, nose, and throat) doctor might also measure the electrical activity of the nerves in the affected area. This helps the doctor know exactly where the paralysis is.

Other conditions, such as asthma [AZ-muh], spasmodic dysphonia [spaz-MOD-ik dis-FOH-nee-uh], and vocal cord dysfunction, can cause the vocal cords to not open or close the way they should. Watching how your child’s vocal cords act and finding out the cause of the condition will help in making the right diagnosis.

Treatment options include:

• Voice therapy. Voice therapy is led by a speech-language pathologist [puh-THOL-uh-jist]. They will teach your child exercises that will make your child’s vocal cords stronger and give them more breath control.
• Surgery. Sometimes, the vocal cords heal without surgery in the first year. Your child’s doctor might want to delay having surgery done to see if they heal on their own. Most surgery options will make the vocal cords be closer to each other. Surgery with a laser (a very strong beam of light) is sometimes done on people who have paralysis of both vocal cords. Usually, the laser is used to make a cut in one vocal cord. After surgery, more voice therapy will be needed. This will be done to help your child get used to how their vocal cords are after surgery and to see how well the surgery worked.
• Tracheotomy [trey-kee-OT-uh-mee]. In some cases, not being able to move both vocal cords makes it very hard to breathe. A tracheotomy may be needed to fix this problem. This procedure makes a hole in the front of the neck for a tube. Your child will then breathe through this tube instead of through their mouth and nose. Voice therapy focuses on helping your child learn to speak while breathing a new way, and teaches them how to care for the tube.

Many causes of vocal cord paralysis cannot be prevented. For example, doctors don’t know how to prevent multiple sclerosis from causing this condition.

It is possible to prevent some cases by being safe. Protect your child’s head, neck, and chest with important safety measures, including:

• Wearing a seat belt
• Wearing a bike helmet
• Using safety gear when playing sports

Avoiding second-hand smoke or other bad air may also help with prevention.

• National Institute on Deafness and Other Communication Disorders
• American Academy of Otolaryngology
• American Speech-Language-Hearing Association

Vocal cord paralysis [puh-RAL-uh-sis] happens when your child can’t move their vocal cords. Paresis is when only one cord can’t move. This condition might be caused by nerve damage, a problem in the brain, injury, infection, or a tumor. The vocal cords are flexible muscles that vibrate to make the sounds your child uses to talk. They need to open when your child breathes and close when your child swallows. Not being able to move one affects how your child talks, eats, and breathes. Not being able to move both can cause your child to stop breathing, which requires a tracheotomy. Other treatments include voice therapy and surgery.