Pediatric vocal cord paralysis

Abstract

Pediatric vocal cord paralysis accounts for approximately 10% of all congenital laryngeal lesions. Early detection of these neurogenic disorders is based upon a high index of suspicion and is important to prevent catastrophes during periods of acute respiratory embarrassment. This paper reviews the symptoms, etiology and management of unilateral and bilateral vocal cord paralysis as it pertains to this age group. A case is presented of a neonate with vocal cord paralysis and associated hydrocephalous and meningomyelocele to illustrate many of the problems associated with pediatric laryngeal paralysis.

Atypical Presentations in Chiari II Malformation

“…The association of laryngeal stridor with MMC and ACM has been reported frequently [3,4,5,6], but recovery within 24 h of the symptoms has never been mentioned. Relief of stridor should theoretically occur after release of traction and compression of the vagus nerve in the posterior fossa [3].…”

“…It is usually associated with ACM. The cause is believed to be stretching of rootlets of the vagus nerve due to coning of hindbrain structures caused by hydrocephalus [3,4,5,6]. The associated hydrocephalus is usually communicating because the foramen of Luschka and Magendie are patent below the level of the foramen magnum; thus, CSF can exit freely, but its reentry is prevented by compression of the subarachnoid space at the foramen magnum.…”

“…Ours is probably the first case where there was spontaneous vocal cord movement as early as 16 h postoperatively and thereby the relief of stridor. It is ideal to perform a shunt surgery within 24 h, when there are symptoms of raised ICP, so as to prevent permanent vocal cord palsy [6]. …”

Obstrucción crónica de la vía aérea en la infancia. Causas más frecuentes. Tratamiento quirúrgico y endoscópico

“…La parálisis de cuerdas vocales es, según la literatura, la segunda causa más importante de estridor crónico infantil [8]. Puede ser congé-nita o adquirida.…”

The use of injectable collagen in the management of pediatric vocal unilateral fold paralysis

“…VFP represents 10-20% of all congenital laryngeal abnormalities, second only to laryngomalacia [2,3]. The recognition of VFP in children is increasing because with advancing technology, including improved fiberoptics and video capture, and the wide spread use of flexible fiberoptic laryngo unrecognized for a longer time than bilateral VFP because the symptoms tend to be less dramatic.…”