title: Bilateral congenital vocal cord paralysis: a 16-year institutional review.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Pediatric tertiary hospital.
  
  
  METHODS
  Twenty-two pediatric patients diagnosed with bilateral congenital true vocal cord paralysis.
  
  
  METHODS
  Flexible or rigid diagnostic evaluation, tracheostomy, and vocal cord lateralization procedures.
  
  
  METHODS
  Vocal cord recovery and decannulation.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology and Communication Disorders, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA. rcmiyamo@iupui.edu
authors.forename: R Christopher
authors.initials: RC
authors.lastname: Miyamoto
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Parikh
authors.forename: Walid
authors.initials: W
authors.lastname: Gellad
authors.forename: Greg R
authors.initials: GR
authors.lastname: Licameli
mesh_terms: D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D014139:Tracheostomy / Q000379:methods; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*