Bilateral congenital vocal cord paralysis: a 16-year institutional review

• Published in: Otolaryngology-head and neck surgery Vol. 133; no. 2; p. 241
• Main Authors: Miyamoto, R Christopher, Parikh, Sanjay R, Gellad, Walid, Licameli, Greg R
• Format: Journal Article
• Language: English
• Published: England 01.08.2005
• Subjects: Cohort Studies; Female; Follow-Up Studies; Hospitals, Pediatric; Humans; Incidence; Infant, Newborn; Intensive Care Units, Neonatal; Laryngoscopy - methods; Male; Otorhinolaryngologic Surgical Procedures - methods; Recovery of Function; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Time Factors; Tracheostomy - methods; Treatment Outcome; Vocal Cord Paralysis - diagnosis; Vocal Cord Paralysis - epidemiology; Vocal Cord Paralysis - surgery
• ISSN: 0194-5998
• DOI: 10.1016/j.otohns.2005.02.019

To review the management and outcome of bilateral congenital true vocal cord paralysis in 22 patients treated over a 16-year period and to review the role of tracheostomy in these patients. Retrospective chart review. Pediatric tertiary hospital. Twenty-two pediatric patients diagnosed with bilateral congenital true vocal cord paralysis. Flexible or rigid diagnostic evaluation, tracheostomy, and vocal cord lateralization procedures. Vocal cord recovery and decannulation. With a mean follow up of 50 months, 15 of 22 patients (68%) with bilateral vocal cord paralysis required tracheostomy for airway securement. Of the 15 tracheotomized patients, 10 were successfully decannulated (8 had spontaneous recovery, whereas 2 required lateralization procedures). Eleven of these patients with tracheostomy had comorbid factors, including neurologic abnormalities (midbrain/brainstem dysgenesis, Arnold-Chiari malformation, global hypotonia, and developmental delay). Of the 7 patients not requiring tracheostomy, 6 recovered vocal cord function (86%). In our series of 22 patients with bilateral vocal cord paralysis, 14 had spontaneous recovery of function. Patients managed with tracheostomy were noted to have a high incidence of comorbid factors. In this series, recovery rates were found to be higher in nontracheostomized patients than in tracheostomized patients. Patients can be carefully selected for observation versus tracheostomy at the time of diagnosis based on underlying medical conditions.