Bilateral Congenital Vocal Cord Paralysis: A 16‐Year Institutional Review

TLDR

The study reviews management and outcomes of bilateral congenital true vocal cord paralysis in 22 pediatric patients over 16 years, focusing on tracheostomy use. A retrospective chart review at a pediatric tertiary hospital documented diagnostic evaluation, tracheostomy, and vocal cord lateralization procedures, and tracked recovery and decannulation over a mean 50‑month follow‑up. Among the cohort, 68 % required tracheostomy, of whom 67 % were decannulated (mostly spontaneously), while 86 % of non‑tracheostomized patients recovered vocal cord function; recovery was higher in non‑tracheostomized patients, suggesting careful selection based on comorbidities.

Abstract

To review the management and outcome of bilateral congenital true vocal cord paralysis in 22 patients treated over a 16-year period and to review the role of tracheostomy in these patients.Retrospective chart review.Pediatric tertiary hospital.Twenty-two pediatric patients diagnosed with bilateral congenital true vocal cord paralysis.Flexible or rigid diagnostic evaluation, tracheostomy, and vocal cord lateralization procedures.Vocal cord recovery and decannulation.With a mean follow up of 50 months, 15 of 22 patients (68%) with bilateral vocal cord paralysis required tracheostomy for airway securement. Of the 15 tracheotomized patients, 10 were successfully decannulated (8 had spontaneous recovery, whereas 2 required lateralization procedures). Eleven of these patients with tracheostomy had comorbid factors, including neurologic abnormalities (midbrain/brainstem dysgenesis, Arnold-Chiari malformation, global hypotonia, and developmental delay). Of the 7 patients not requiring tracheostomy, 6 recovered vocal cord function (86%).In our series of 22 patients with bilateral vocal cord paralysis, 14 had spontaneous recovery of function. Patients managed with tracheostomy were noted to have a high incidence of comorbid factors. In this series, recovery rates were found to be higher in nontracheostomized patients than in tracheostomized patients. Patients can be carefully selected for observation versus tracheostomy at the time of diagnosis based on underlying medical conditions.