Vocal Fold Mobility Impairment

  • Karen B. ZurEmail author
  • Kimberly Duffy
  • Linda M. Carroll


Vocal fold immobility in children remains complex and multidisciplinary, affecting overall respiratory and nutritional health as well as speech-language development, social development, and education. Immobility may occur due to cardiac surgery in the neonate, as a sequela to thyroid, pulmonary, or esophageal surgery, due to prolonged or repeated intubation, due to genetic disorders, or from idiopathic events. Gestational age may also factor into vocal fold immobility. Both flexible laryngoscopy and ultrasonography are effective in determining the presence of vocal fold immobility. While confirmation of vocal fold paralysis can only be accomplished through laryngeal electromyography (LEMG), options for management of vocal fold immobility include observation, voice therapy, or surgical intervention. Severity of impairment is the greatest factor in determining best short-term and long-term management. Due to a naive neck for the majority of children with vocal fold paralysis, laryngeal reinnervation offers the best promise for management of moderate to severe cases.


Vocal fold paralysis Pediatric voice Swallow in pediatric patients Reinnervation in vocal fold Injection laryngoplasty 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Karen B. Zur
    • 1
    • 2
    • 3
    Email author
  • Kimberly Duffy
    • 4
  • Linda M. Carroll
    • 5
  1. 1.Pediatric Voice ProgramCenter for Pediatric Airway DisordersPhiladelphiaUSA
  2. 2.Otorhinolaryngology – Head and Neck SurgeryChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  3. 3.Perelman School of Medicine at the University of PhiladelphiaPhiladelphiaUSA
  4. 4.Speech-Language PathologyChildren’s Hospital of Philadelphia, The Center for Childhood CommunicationPhiladelphiaUSA
  5. 5.Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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