Pediatric vocal fold paralysis - A long-term retrospective study

Objective: To review our experience of pediatric vocal fold paralysis (VFP) , with particular emphasis on etiological factors, associated airway pathol ogic conditions, and treatment and prognostic outcomes. Design: Retrospective case review of a cohort of patients presenting with V FP. Setting: Tertiary referral center. Patients: A consecutive sample of 102 patients presenting with VFP to Great Ormond Street Hospital for Children, London, England, over a 14-year perio d from 1980 to 1994. Results: There was an almost equal distribution of unilateral (52% [n = 53] ) and bilateral (48% [n = 49]) VFP. latrogenic causes (43% [n = 44]) formed the largest group, followed by idiopathic VFP (35% [n = 36]), neurological causes (16% [n = 16]), and finally birth trauma (5% [n = 5]). Associated u pper airway pathologic conditions were noted in 66% (n = 23) of patients wh o underwent tracheotomy. Tracheotomy was necessary in only 57% (n = 28) of children with bilateral VFP. Prognosis was variable depending upon the caus e, with neurological VFP hating the highest rate of recovery (71% [5/7]) an d iatrogenic VFP the lowest rate (46% [12/26]). Conclusion: Recovery after an interval of up to 11 years was seen in idiopa thic bilateral VFP; this has significant implications when considering late ralization procedures in these patients.