Bilateral Vocal Cord Paralysis (BVCP)

What Is Bilateral Vocal Cord Paralysis?

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

There are two types of VCP: 

1. Both vocal cords do not move, called bilateral vocal cord paralysis (BVCP)

2. Only one vocal cord moves, called unilateral vocal cord paralysis (UVCP)

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

A child can be born with BVCP or it can result from another body system problem that affects vocal cord movement.

  • The newborn can have a high-pitched sound that worsens when the child gets upset or cries; this is called stridor.
  • Usually infants have trouble breathing, and may 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 well (also called aspiration).
  • The child may choke or cough during feedings.

If BVCP is suspected, a flexible scope with a camera 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 around the vocal cords. This will show whether the vocal cords move or not.

If the doctor feels there is a defect in the structure around the vocal cords, 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. 

The goals of BVCP treatment are to maintain a safe and stable airway, preserve speech and allow safe swallowing 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 BVCP. Management of BVCP depends on the cause of the BVCP. Surgery to correct BVCP is usually delayed at least a year to see if the vocal cords recover and move on their own.

Last Updated 07/2014