To review our experience with endoscopic coblation-assisted and partial arytenoidectomy (ECPA) in treating idiopathic bilateral vocal cord paralysis (BVCP). A retrospective analysis of thirty-three infants (19 boys and 14 girls, aged 1–10 months) with idiopathic BVCP undergoing ECPA was performed. The therapeutic process and outcomes (surgical success, swallowing function, and voice) were reviewed. The follow-up period was >33 months. Among the thirty-three infants with idiopathic BVCP, surgery was successful in twenty-nine cases but failed in four cases. Twenty-one, nine, and three patients underwent right, left, and bilateral ECPA, with surgical success rates of 90.5%, 100.0%, and 33.3%, respectively. In addition, four and six cases were combined with subglottic stenosis (SGS) and laryngomalacia, respectively. The surgical success rates of BVCP alone and BVCP+ other airway abnormalities were 95.6% and 70.0%, respectively. During the follow-up, five infants had slight difficulty swallowing, 12 infants had partial or complete recovery movement of at least one vocal cord with satisfactory voice outcome, and five infants had early granuloma formation, which disappeared spontaneously. ECPA appears to be a promising alternative to tracheostomy and initial management in infants with idiopathic BVCP who are free of other airway abnormalities.

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