title: Paralyzed neonatal larynx in adduction. Case series, systematic review and analysis.
abstract: OBJECTIVE
  Bilateral vocal cord abductor paralysis (BVCAbP) is considered a rare cause of stridor in the newborn. The goal of this work is to present a case series and to review systematically the literature on bilateral vocal cord abductor paralysis in the newborn to better characterize the current knowledge on this entity.
  
  
  METHODS
  We performed a systematic literature review with Medline (1950-2011). The authors screened all cases of BVCAbP reported and selected those affecting newborns.
  
  
  RESULTS
  Out of the 129 articles screened, 16 were included. A total of 69 cases could be retrieved and analyzed. Associated co-morbidities were found in 54% of the patients, most notably malformative conditions (intracranial or other), or a positive perinatal history (trauma/asphyxia, prematurity). Tracheostomy placement was required in 59% of children, and of these 44% were successfully decannulated. In terms of functional outcome full recovery or improvement were seen in 61% of patients. Major underlying co-morbidities affected negatively the functional outcome (p=.004), but not the need for tracheostomy (p=.604) or the decannulation success rate (p=.063).
  
  
  CONCLUSIONS
  BVCAbP in the newborn is a serious cause of airway obstruction. It can be seen either in a context of multisystem anomalies or as an isolated finding. Newborns with major co-morbidities affecting their normal development are more likely to have poor functional outcomes and to remain tracheostomy-dependant.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Hôpital de Sion - CHCVs/RSV, Avenue du Grand Champsec 80, 1950 Sion, Switzerland. llnisa@yahoo.ca
authors.forename: L
authors.initials: L
authors.lastname: Nisa
authors.forename: F
authors.initials: F
authors.lastname: Holtz
authors.forename: K
authors.initials: K
authors.lastname: Sandu
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D012135:Respiratory Sounds / Q000175:diagnosis / Q000209:etiology; D015619:Respiratory System Abnormalities / Q000175:diagnosis / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D014139:Tracheostomy / Q000379:methods; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000150:complications* / Q000151:congenital* / Q000601:surgery