Health Library

Bilateral Vocal Cord Paralysis (BVCP)

What Causes BVCP?

A child can be born with BVCP or it can result from another body system problem that affects vocal cord movement. It is often associated with trauma during birth and abnormalities such as Chiari malformations or increased pressure within the skull (intracranial). However, often the cause is unknown.

Additional potential causes include:

• Delayed development of the nerves and brain centers that cause vocal cord movement
• 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

What Are the Signs and Symptoms?

A 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.

How is Bilateral Vocal Cord Paralysis Diagnosed?

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 under anesthesia.

When Should You Call Your Doctor?

If your child has difficulty breathing or their lips or face have a blue appearance, call 911.

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