In This Section      

Vocal Cord Paralysis

The vocal cords are connected to nerves that allow the voice to make sound. When they do not move, they are considered paralyzed. There are two types of vocal cord paralysis:

  1. Bilateral vocal cord paralysis: Neither vocal cord can move.
  2. Unilateral vocal cord paralysis: Only one vocal cord cannot move.

Vocal cord paralysis in children can be caused by:

  • Delayed development of the nerves and brain centers that cause vocal cord movement
  • Trauma to the head, neck and chest
  • Illness and/or infections
  • Surgery on the neck or chest, including heart surgery
  • History of breathing tube placement
  • Head, neck or chest masses

The benefit of an evaluation by one of the pediatric otolaryngologists (ENTs) at the Johns Hopkins Division of Pediatric Otolaryngology is that we offer comprehensive care. Whatever the cause of your child’s vocal cord paralysis, our experts are experienced and can offer a variety of treatment options, including surgery, speech therapy and swallowing therapy.

Symptoms and signs of vocal cord paralysis

Your child may have the following symptoms or signs:

  • Stridor: Noise when breathing in and out, or both
  • Shortness of breath
  • Hoarseness
  • Tire easily with activity
  • Coughing with swallowing foods


  1. Your doctor will obtain a complete medical history and will perform a thorough physical examination.
  2. Flexible laryngoscopy: A flexible fiberoptic laryngoscopy is typically performed. During this procedure, a small flexible tube with a tiny camera is passed through the mouth or nose to examine the nasal passages, vocal cords, larynx, and upper airway. This is most helpful to visualize the structures and how they move to diagnose the cause of hoarseness. This is a brief and mildly uncomfortable, but not painful procedure, usually done during an office visit without any sedating medications.


There are several different ways to manage vocal cord paralysis in children; however, follow-up care is imperative to insure you child’s symptoms improve. Your doctor may recommend:

  • Speech and language therapy to improve the voice
  • Doing nothing. Vocal cord paralysis can often resolve without specific treatment.
  • Surgery. Surgical treatment is recommended when there are nodules and polyps that need to be removed from the vocal cords; if swallowing or breathing difficulties are a problem; or, if there are other problems that only surgery can treat.

Request an Appointment

Please call us at 443-997-6467 (443-997-OHNS) to make an appointment at any of our three locations.