Pediatric Airway Disorders Guide

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Unilateral Vocal Cord Paralysis (UVCP)

What is Unilateral Vocal Cord Paralysis?

Vocal cords vibrate to make sound. Vocal cords also close when you swallow. They protect your airway from food and saliva going into your lungs. When vocal cords do not move, they are considered paralyzed.

There are two types of vocal cord paralysis:

  1. Both vocal cords do not move, called bilateral vocal cord paralysis (BVCP)
  2. Only one vocal cord does not move, called unilateral vocal cord paralysis (UVCP)

Even though the two are related, the causes and management for each condition are different.

Cause of UVCP
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UVCP can result from an injury to the nerve that controls the movement of the vocal cords resulting from:

  • Some type of trauma to the head, neck or chest
  • Illness and/or infections
  • Neck, chest or heart surgery
  • History of breathing tube placement
  • Head, neck or chest tumors

UVCP can also be caused by delayed development of the nerves and brain centers that control vocal cord movement or the cause may be unknown (idiopathic).

Signs and Symptoms
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  • The child can have a high pitched or "squawking" sound when he or she gets upset or cries. This is called stridor.
  • The child’s voice can be hoarse.
  • The child can have occasional shortness of breath.
Diagnosis of UVCP
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A flexible telescope is passed through the nose to just above the level of the vocal cords while the child is awake. The flexible scope will give a close-up view of the vocal cords and other parts of the airway surrounding the vocal cords. The scope will show whether the vocal cords move or not.

Treatment of UVCP
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Doctors in multiple disciplines work together to determine the best course of action for your child. Unilateral vocal cord paralysis generally does not need treatment. The airway is usually stable with no breathing or feeding problems. The quality of voice may not be normal. The mobile vocal cord may make up for the paralyzed vocal cord and voice quality or volume may improve over time.

Call Your Child’s Doctor If:
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If your child has difficulty breathing or his / her lips or face have a blue appearance, call 911.

Call your child’s doctor if your child struggles to swallow his / her food, coughs or chokes often when eating or is not gaining weight.