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Vocal cord paralysis in children 1 year of age and younger
Insights
Vocal cord paralysis in infants is often diagnosed in males and can be bilateral. While some cases resolve spontaneously, accurate diagnosis using fiberoptic laryngoscopy is crucial for proper management.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Neurology
Background:
- Vocal cord paralysis (VCP) in infants presents unique diagnostic and management challenges.
- Unilateral or bilateral VCP can significantly impact an infant's airway and feeding.
- Etiologies of VCP in neonates and infants are diverse, requiring thorough investigation.
Purpose of the Study:
- To analyze the causes, clinical features, and outcomes of unilateral or bilateral vocal cord paralysis in young children.
- To emphasize the diagnostic utility of fiberoptic laryngoscopy in pediatric VCP cases.
- To review the long-term resolution rates and management strategies for infant VCP.
Main Methods:
- Retrospective chart review of 22 patients diagnosed with VCP between 1962 and 1985.
- Analysis of patient demographics, etiology, laterality of paralysis, interventions, and follow-up data.
- Correlation of diagnostic methods, specifically fiberoptic laryngoscopy, with clinical outcomes.
Main Results:
- A total of 22 infants (≤1 year) were diagnosed with VCP, with a male predominance.
- Bilateral VCP occurred in 12 patients, often requiring tracheotomy.
- Identified etiologies included congenital neurological malformations (6), birth trauma (5), surgery (4), syphilis (1), and idiopathic (6).
- Of 16 patients with follow-up, 10 experienced resolution of paralysis between 1 week and 5 years of age.
Conclusions:
- Infant vocal cord paralysis has varied etiologies, with congenital and birth-related factors being prominent.
- Accurate and timely diagnosis, particularly with fiberoptic laryngoscopy, is essential for appropriate management.
- While many cases show spontaneous resolution, long-term monitoring and intervention may be necessary.
Abstract:
Twenty-two patients 1 year of age or younger were diagnosed as having unilateral or bilateral vocal cord paralyses between 1962 and 1985. There was a marked male predominance, and 12 of the paralyses were bilateral. Congenital neurological malformations were the cause in six patients, birth trauma in five, surgery in four, syphilis in one, and six cases were idiopathic. Tracheotomy was necessary in 11 of the patients with bilateral paralyses. Ten of the 16 patients for whom follow-up was available had resolution of the paralysis from 1 week to 5 years of age. The importance of making an accurate diagnosis is stressed, as is using the fiberoptic laryngoscope.