Bilateral idiopathic vocal cord palsy.

Area of Science:

• Pediatric Otolaryngology
• Pediatric Pulmonology
• Neurology

Background:

• Bilateral vocal cord palsy (BVCP) is a rare condition that can lead to significant upper airway obstruction in children.
• Acute respiratory distress in pediatric patients often necessitates prompt diagnosis and management of airway compromise.

Observation:

• Three pediatric cases of BVCP presented with acute respiratory distress and signs of upper airway obstruction.
• These children required tracheostomy to secure their airway due to the severity of the obstruction.
• Extensive clinical evaluation and laboratory investigations failed to identify an underlying cause for the palsy in these cases.

Findings:

• The presented cases highlight the potential for idiopathic BVCP to manifest as a critical upper airway emergency in children.
• Laryngoscopic examination is crucial for diagnosing vocal cord immobility and assessing the degree of airway obstruction.

Implications:

• Pediatricians and emergency physicians should consider idiopathic BVCP in the differential diagnosis of acute upper airway obstruction in children.
• Early recognition and diagnosis through laryngoscopy can prevent severe respiratory compromise and guide appropriate management, including tracheostomy when necessary.