VOCAL FOLD PARALYSIS IN INFANTS 12 MONTHS OF AGE AND YOUNGER

Seventeen cases of unilateral or bilateral vocal fold paralysis were d iagnosed in infants younger than 12 months from 1991 to 1994 at the Un iversity of Iowa Hospitals and Clinics, Eight (47%) children with left vocal fold paralysis had a history of prior thoracic surgery-two to r epair complex congenital anomalies and six to ligate a patent ductus a rteriosus, During the study period, a total of 81 patent ductus arteri osus ligations were performed, yielding a 7.4% postoperative incidence of vocal fold paralysis, Seven (41%) children had idiopathic vocal fo ld paralysis (3 right, 1 left, 3 bilateral), Two (12%) children had VF P caused by central nervous system pathology (1 right, 1 bilateral), T racheotomy was not required in any case, Prognosis for vocal fold para lysis varied with cause. With left vocal fold paralysis caused by thor acic surgery, no improvement was noted after an average follow-up of 6 months; with idiopathic vocal fold paralysis infants improved within an average of 6 weeks of diagnosis; with vocal fold paralysis caused b y central nervous system pathology, treatment of the underlying condit ion was followed by return of vocal cord function, Irrespective of cau se, the morbidity associated with vocal fold paralysis is minimal, Alt hough tracheotomy is not required, careful airway observation is impor tant, Differences and similarities of these results with other studies are discussed.