Natural history of tracheostomy-dependent idiopathic congenital bilateral vocal fold paralysis

Abstract

Objective To identify the age at which spontaneous improvement in vocal fold function occurs that will allow decannulation to be performed in tracheostomy-dependent children with isolated idiopathic congenital bilateral vocal fold paralysis (BVFP). Study Design And Setting Retrospective chart review in tertiary pediatric center. Results Three children were identified who underwent tracheostomy between 13 and 45 days old. Two patients have been decannulated at age 5 years 11 months and 7 years 1 month, but both have persistent symptoms of upper airway obstruction. One patient remains tracheostomy-dependent at 4 years of age with only minimal vocal cord abduction. Conclusions Spontaneous improvement in vocal fold function sufficient to allow decannulation appears to occur during the second quinquennium of life. Significance Conservative treatment could be considered as an alternative to surgery in severe idiopathic congenital BVFP.