title: The natural history of vincristine-induced laryngeal paralysis in children.
abstract: OBJECTIVE
  To outline the natural history of vincristine-induced laryngeal paralysis (VLP) in children.
  
  
  METHODS
  Retrospective case series and review of reported cases in the English-language literature.
  
  
  METHODS
  Tertiary pediatric center.
  
  
  METHODS
  The study included all children with a confirmed diagnosis of VLP by inspection and with complete clinical information. The sources for patient identification were a prospectively kept database and a review of the English-language literature, conducted on PubMed since 1966, as well as a bibliography search.
  
  
  METHODS
  Charts and literature were reviewed for demographics, primary diagnosis, other diagnoses, and duration and method of treatment. The prevalence of VLP, locally, was also calculated.
  
  
  RESULTS
  Four children (3 boys and 1 girl) were identified in our database over a 5(1/2)-year period, and 10 children (1 girl, 8 boys, and 1 with sex omitted) were described in the English-language literature. Four children had unilateral vocal fold paralysis only, all left-sided. The median age was 2.6 years. Acute lymphoblastic leukemia was the underlying diagnosis in 8 patients. Two patients had Down syndrome, and 1 patient had Charcot-Marie-Tooth disease, type 1. Only 2 patients required tracheotomies, and 1 patient was treated temporarily with bilevel positive-pressure ventilation. The median duration of paralysis was 6.8 weeks. The prevalence of VLP was 1.36%.
  
  
  CONCLUSIONS
  The data suggest that VLP is probably underreported and possibly underdiagnosed. Endoscopic inspection is a must in all patients with airway symptoms who are receiving vincristine therapy. Early recognition of VLP is mandatory, as it is reversible, has a good prognosis, and usually needs only interruption of vincristine therapy and conservative treatment.
authors.affiliation: Pediatric Otolaryngology Service, Division of Pediatric Surgery, The Stollery Children's Hospital, Edmonton, Alberta, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Kuruvilla
authors.forename: Shirley
authors.initials: S
authors.lastname: Perry
authors.forename: Beverly
authors.initials: B
authors.lastname: Wilson
authors.forename: Hamdy
authors.initials: H
authors.lastname: El-Hakim
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D012189:Retrospective Studies; D014750:Vincristine / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000139:chemically induced*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine