Bilateral congenital vocal cord paralysis: a 16-year institutional review.
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.
Miyamoto
R Christopher
RC
Department of Otolaryngology and Communication Disorders, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA. rcmiyamo@iupui.edu
Parikh
Sanjay R
SR
Gellad
Walid
W
Licameli
Greg R
GR
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*