ARYTENOIDECTOMY IN CHILDREN

Vocal cord paralysis is the second most common cause of strider in ear ly infancy, and as many as 52% of patients will not recover spontaneou sly. Bilateral vocal cord paralysis often requires a tracheotomy for a irway distress. If resolution of the bilateral vocal cord paralysis do es not allow for decannulation, arytenoidectomy is an option. A retros pective review of 30 children with bilateral vocal cord paralysis who underwent an arytenoidectomy was undertaken. An external arytenoidecto my via laryngofissure was performed in 19 patients, a laser arytenoide ctomy in 12 patients, and a Woodman procedure in 1 patient. Twenty-fiv e of the 30 patients (83%) were decannulated. Decannulation was more l ikely after a laryngofissure (84%) than after a laser arytenoidectomy (56%). The probability of decannulation was related to the presence of concomitant conditions and the need for other airway procedures. Whil e breathiness, hoarseness, and pitch change were common, all patients had an adequate voice postoperatively and demonstrated little change f rom the preoperative voice disturbance. Aspiration was a rare complica tion. After an adequate period of observation for spontaneous resoluti on, arytenoidectomy via external laryngofissure is recommended to aid in the decannulation of children with bilateral true vocal cord paraly sis.