Vocal cord surgeries improve Oliver’s breathing

The Wiseman family is grateful to have Akron Children’s ENT experts so close to home.

Malikai Wiseman of Green had a routine pregnancy and delivery at Summa Health. But her baby boy, Oliver, had trouble breathing. He went from the nursery to the Neonatal Intensive Care Unit (NICU).

“I was 20 years old when Oliver was born. Being a young parent is scary in and of itself,” Malikai said. “Then you find out you have a medically complex child, and everything feels uncertain.”

Pediatric ear, nose and throat (ENT) specialist Dr. Marc Nelson met Oliver in the NICU. “He had vocal cord paralysis,” Dr. Nelson said. “Both of his vocal cords didn’t move and were closed, which limited his breathing.”

Vocal cords are 2 small muscles inside your voice box. They open when you breathe in and out, so air flows freely. When you talk, your vocal cords close and vibrate to make the sound of your voice. Vocal cords also help you breathe and swallow food and drinks safely.

“Oliver had a strong cry because of his closed vocal cords,” Dr. Nelson said. “But they didn’t open much when he took a breath.”

Typical treatment for Oliver’s condition is a “tracheotomy,” or trach. This surgery involves opening the neck and placing a tube that allows air to skip the nose and mouth – and go straight to the lungs. “In some cases, the vocal cord paralysis improves with time,” Dr. Nelson explained. “We wanted to help Oliver in a way that didn’t damage his chances of getting spontaneous return of function.”

Two ENT surgeries helped Oliver have better quality of life.

Oliver’s first surgery

Instead of a tracheotomy, Dr. Nelson performed a new procedure when Oliver was just a few weeks old. “We cut the cricoid – which is a ring of cartilage around the windpipe – in the front and back,” he said. “Then we use a specialized balloon to stretch the cut and gently keep the two halves apart to open the airway. The procedure allowed us to spread Oliver’s vocal cords enough to avoid doing a trach.”

In addition to the vocal cord paralysis, Oliver had “laryngomalacia.” This is a condition when soft tissues above the voice box fall over the airway, causing a high-pitched sound during breathing. “When you fill up a balloon and it squeaks as you squeeze the air out, that’s what Oliver’s throat was doing,” Malikai shared. “Dr. Nelson removed some of the extra tissue, and that cleared up the problem.”

Oliver had more breathing trouble as he grew. “If he got upset, really excited or laughed a lot, he would literally turn blue,” Malikai said. “It was scary. My husband, Garett, and I just wanted Oliver to have better quality of life.”

He also struggled to gain weight. “The vocal cord function never came back, so Oliver spent a lot of calories on the ‘work’ of breathing,” Dr. Nelson said. “He also developed a pectus, which means his chest is sunken in, likely because of the restrictive nature of his breathing.”

Oliver has a T-shaped rib graft between his vocal cords, which will grow as he grows.

Oliver’s second surgery

Dr. Nelson previously told the Wisemans that if the initial cricoid split didn’t provide enough relief, he could separate Oliver’s vocal cords with a T-shaped rib graft. “We harvested a piece of Oliver’s rib and placed it between his vocal cords,” Dr. Nelson explained. “The graft will be in place for the rest of his life, and it will grow along with him.”

Doing the grafting surgery endoscopically avoids further instability of the structures, which can occur with open procedures through the neck. “I’m proud of how we’ve helped Oliver, doing so without any incisions in his neck,” Dr. Nelson said. “We are able to provide all nature of complex airway surgeries at Akron Children’s, which allows families to stay close to home for surgery and follow-up care.”

The grafting surgery took place in June 2025, just before Dr. Nelson left for a planned vacation. “ENT Division Director Dr. Julie Wei was able to seamlessly transition Oliver’s care management during the postoperative period. She removed the nasal tube in the operating room, which we used as a stent to let Oliver’s rib graft heal, and replaced it with an oral one,” Dr. Nelson shared. “She got to know the Wiseman family during his hospitalization and kept me posted while I was away. Everything looked good, and Oliver healed well.”

Now that he’s breathing better, 3-year-old Oliver is full of energy.

The Wisemans ‘roll with it’

Oliver has overcome so much in a few short years. While the surgeries improved his breathing, his vocal cords still don’t close in a typical way. As a result, he gets fed through a tube in his stomach. He will soon start speech and feeding therapy, with the goal of eating safely by mouth.

“The Wisemans have been very easy to work with,” Dr. Nelson said. “They just roll with it, adapting to whatever circumstances come their way.”

Malakai praises the Akron Children’s team for taking such good care of Oliver. “From the NICU to surgery and recovery, we’ve basically seen the entire Akron campus,” she said. “But everyone who has cared for Oliver has been wonderful, especially Drs. Nelson and Wei. They not only have great surgical experience and knowledge, but they’re kind and compassionate.”