Researchers from Mass Eye and Ear, a member of Mass General Brigham reported a first pediatric case of bilateral vocal cord paralysis after COVID infection.
The researchers concluded that the 15 year old teenage girl was suffering from the aftereffect of the COVID infection as bilateral vocal cord paralysis due to neurological involvement of post viral infection. According to the study, examination with an endoscope showed bilateral vocal cord paralysis which is total immobility of the vocal cords in the larynx. Larynx is also known as the Voice Box of the human body.
She was presented after 13 days of COVID 19 infection with symptoms of shortness of breath, increased respiratory rate, after endoscopic examination bilateral vocal cord paralysis is confirmed. She had history of asthma. The patient underwent tracheostomy, a surgically created opening in windpipe with placement of the tracheostomy tube, immediately. She was tracheostomy dependent for 13 months after initial treatment suggesting that this kind of post viral neurological complication is not temporary.
After submission of the report, the physicians were able to remove her tracheostomy tube 15 months after insertion as she has high school graduation and prom. She told doctors that she is not going to high school graduation with a tracheostomy tube.
It is the first reported case of post viral neuropathy complication vocal cord paralysis in the adolescent. The case report was published on December 19 in Journal Pediatrics.
Vocal cord pathology must be a differential while examining a child with post COVID infection with complaints of difficulty in breathing and swallowing problems.
Vocal Cord are flexible bands of muscle at the opening of the trachea which have a function to produce sound. When we speak, these vocal cords vibrate and make sound out of it.
Bilateral Vocal Cord Paralysis
Unilateral vocal cord paralysis is very much common. It causes symptoms like breathing difficulty, swallowing difficulty, speech problems but bilateral vocal cord paralysis is a very rare complication in which patients suffer from difficulty in breathing due to closure of the windpipe due to relaxation of the vocal cords and respiratory distress which needs surgical procedure as it becomes an emergency.
Hoarseness of voice, noisy breathing, shortness of breath, coughing while swallowing, inability to speak loudly are symptoms of vocal cord paralysis. The complications of vocal cord paralysis are mild for unilateral paralysis but bilateral vocal cord paralysis can present with dreadful complications.
The treatment of vocal cord paralysis totally depends on severity of disease which range from speech therapy, injections to surgical procedure as well.
Conclusion Of Study
Pediatric population may suffer from rare bilateral vocal cord paralysis after post COVID infection in the adolescent age group.