Children's Vocal Fold Palsy Service
At Southampton Children’s Hospital, University Hospital Southampton I am proud to be part of the first Paediatric Laryngeal Reinnervation Service in the UK alongside world-leading experts Dr Kate Heathcote, Dr Andrea Burgess, and Dr David Allen. Together, we offer a collaborative, innovative and holistic approach to management, with laryngeal reinnervation being one of the most advanced options for improving the quality of life for children with vocal fold palsy.
Unilateral Vocal Fold Palsy (one vocal fold paralysed)
Unilateral vocal fold palsy in children can impact speech, swallowing, and breathing, leading to a weak voice, feeding difficulties, and aspiration. This can cause social and communication challenges. Early intervention and support are crucial for improving quality of life.
Bilateral Vocal Fold Palsy (both vocal folds paralysed)
Bilateral vocal fold palsy can cause breathing difficulties, stridor, and airway obstruction in children, sometimes leading to respiratory distress. In severe cases, a tracheostomy may be required. The condition can significantly impact the child and family, but speech is often preserved. Early intervention is crucial for managing airway concerns.
Laryngotracheobronchoscopy
Laryngotracheobronchoscopy is a procedure that examines your child’s voice box (larynx), windpipe (trachea), and airways using a lighted telescope. Performed under general anaesthesia, it helps doctors investigate breathing problems and determine the cause, aiding in appropriate diagnosis and treatment to improve your child's respiratory health.
Laryngeal Electromyography
Laryngeal Electromyography records electrical activity from the laryngeal (voice box) muscles, helping assess neuromuscular function and predict if nerve damage may recover. The results are reviewed by the neurophysiology and ENT team, who, in collaboration with parents, create a plan for the child’s treatment and potential recovery.
Non- Selective Laryngeal Reinnervation
For children with unilateral vocal fold palsy options include conservative care, speech and swallowing therapy, vocal fold injection and reinnervation techniques. Non-selective laryngeal reinnervation is a procedure to improve muscle tone and bulk on one side of the voice box. It’s performed under general anaesthesia through a small neck incision. The surgery connects nerves to help improve voice quality and aspiration. Recovery may take up to 20 months. Risks include persistent cough, weak voice, pain, bleeding and infection.
Bilateral Selective Laryngeal Rinnervation
For children with bilateral vocal fold palsy (BVFP), treatment options include conservative care, speech and swallowing therapy, Botox, endoscopic techniques to widen the airway and if needed tracheostomy for severe airway obstruction. Bilateral selective laryngeal reinnervation is a surgery undertaken in suitable cases of bilateral vocal fold palsy (BVFP). It aims to restore movement in both vocal folds, improving airway management. The procedure involves connecting nerves to help the muscles work properly.
This Service is based at Southampton Children's Hospital, University Hospital Southampton
For NHS patients referral to this tertiary service is required