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Vocal cord palsy in pediatric practice: a review of 71 cases
Insights
This study reviewed 71 vocal cord palsy cases in children. Congenital cases showed lower spontaneous recovery rates than acquired ones, highlighting the need for conservative management.
Area of Science:
- Pediatric Otolaryngology
- Neurology
- Speech and Hearing Sciences
Background:
- Vocal cord palsy (VCP) is a condition affecting children's voice and breathing.
- Understanding the etiology and outcomes of VCP is crucial for effective management.
- Bilateral VCP was observed in 44% of the reviewed cases.
Purpose of the Study:
- To review the etiology, management, and outcomes of vocal cord palsy in pediatric patients.
- To analyze spontaneous recovery rates for acquired versus congenital VCP.
- To inform clinical decision-making regarding surgical intervention for pediatric VCP.
Main Methods:
- Retrospective case review of 71 children diagnosed with vocal cord palsy over 20 years.
- Analysis of etiological factors, treatment approaches, and patient outcomes.
- Comparison of spontaneous recovery rates between acquired and congenital VCP.
Main Results:
- 64% of acquired vocal cord palsies showed spontaneous recovery.
- Only 29% of congenital vocal cord palsies recovered spontaneously.
- Late spontaneous recovery or compensation is a significant factor in pediatric VCP management.
Conclusions:
- Management of pediatric vocal cord palsy should consider the potential for late spontaneous recovery or compensation.
- Surgical intervention to permanently lateralize vocal cords or arytenoids should be approached cautiously in children.
- A conservative management approach is recommended, avoiding premature surgical procedures.
Abstract:
Seventy-one cases of vocal cord palsy were seen over a 20-year period at the Hospital for Sick Children in Toronto. Forty-four percent of the cases had a bilateral vocal cord palsy. The etiology, management and outcome of all the cases are reviewed. Of the acquired vocal cord palsies, 64% recovered spontaneously. Only 29% of the congenital vocal cord palsies recovered spontaneously. An important consideration in the management of children with vocal cord palsy is the possibility of late spontaneous recovery or compensation. There should, therefore, be no hurry to perform surgical procedures to permanently lateralize the vocal cords or arytenoids.