Health Topics

• The newborn can have a high pitched or "squawking" sound that worsens when the child gets upset or cries; this is called stridor.
• Usually infants have difficulty breathing, turn blue or have pauses in breathing.
• The child may have frequent pneumonias because liquids and / or food go into the airway and the child is unable to cough effectively (also called aspiration).
• The child may have feeding difficulties, such as choking or coughing during feedings.

If bilateral vocal cord paralysis is suspected, a flexible telescope is passed through the nose and throat while the child is awake. The flexible scope will give a close-up view of the vocal cords and other structures surrounding the vocal cords. This will show whether the vocal cords move or not.

If a structural abnormality around the vocal cords is thought to be the cause, a Microscopic Laryngoscopy and Bronchoscopy (MLB) may be needed to look at the airway below the level of the vocal cords. This is done in the operating room with the child being sedated by general anesthetic.

The goals of bilateral vocal cord paralysis treatment are to maintain a safe and stable airway, preserve speech, allow safe swallowing without aspiration and weight gain.

A tracheotomy, a surgical procedure that creates an opening in the windpipe, is usually required to maintain a safe and stable airway.

Further testing is done to find the underlying cause of the bilateral vocal cord paralysis. Management depends on the cause of the bilateral vocal cord paralysis. Surgery to correct bilateral vocal cord paralysis is usually delayed at least a year to see if the vocal cords recover and move on their own.