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Vocal cord palsy following cardiac surgery fact sheet

Vocal cord palsy following cardiac surgery

What is vocal cord palsy?

The vocal cords are two bands of tissue that sit at the opening of the trachea (windpipe) within the larynx (voice box). The vocal cords open to allow airflow in and out of the lungs during breathing. They close together to produce vibrations (sound) used for speaking. They also close during swallowing to prevent food or fluid from entering the windpipe and lungs.

Vocal cord palsy (VCP) is a condition in which the vocal cords cannot move, or have weak or reduced movement, on one or both sides.

The nerves that control the vocal cords loop around arteries near the heart, and can therefore be impacted by some types of heart surgery.

vocal cord positions

Vocal cord palsy may lead to:

  • ‘Squeaky’ or noisy breathing (stridor)
  • A breathy, weak voice
  • A hoarse, quiet or silent cry in infants
  • Food or fluids entering the windpipe or lungs during swallowing (aspiration)

How is it assessed?

If there are concerns after surgery that your child may have VCP then you will be referred to an Ear Nose and Throat specialist (ENT). They will come to see your child on the ward and often will look at their vocal cords with an instrument called a ‘scope’ to assess how the vocal cords are moving. An ultrasound machine can also be used by a sonographer to see if there is reduced movement of either vocal cord.

How is it treated?

In most cases, no immediate treatment is required, however your child may need help to prevent food or fluid ‘going down the wrong way’ into the windpipe.

Over time, some children may have spontaneous improvement in their vocal cord movement (with improvement in their voice and swallowing) due to:

  • recovery of the nerve controlling the affected vocal cord
  • the unaffected vocal cord compensating for the weaker cord

It is difficult to predict how much recovery will occur, or how long this recovery will take. The ENT team can discuss this further with you.

If needed, voice therapy can also be helpful when your child is talking and old enough to participate in play-based voice and breathing exercises.

Can my child breast/bottle feed, or eat and drink?

All children with vocal cord palsy following heart surgery will be assessed by a Speech Pathologist and supported to develop or recommence oral feeding wherever possible. Speech Pathology treatment will focus on strategies to keep your child safe, and prevent fluid or food entering the airway during breast or bottle feeding, or while eating and drinking.

Useful links

Contact your Speech Pathologist or ENT if you have any questions or concerns about your child’s vocal cord function or feeding and swallowing.

Contact us

Speech Pathology Department – Cardiac Team
Level 6a, Queensland Children’s Hospital
501 Stanley Street, South Brisbane QLD 4101
t: 07 3068 2375

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Resource No: FS338. Developed by the Speech Pathology Department Queensland Children’s Hospital. Updated: January 2019. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.