Endoscopic management of vocal fold paralysis

Abstract

Vocal fold paralysis is a challenging disorder to manage in the pediatric population. While many cases may be managed expectantly, patients with problematic dysphonia, aspiration, or dyspnea may require surgical intervention. Tracheostomy was performed in nearly all patients with bilateral vocal fold paralysis and some patients with unilateral vocal fold paralysis in the past. However, with modern endoscopic and open procedures for vocal fold paralysis, current tracheostomy rates have decreased to 4%-69%. Endoscopic interventions are particularly advantageous in children given high rates of eventual recovery. The perioperative considerations, indications, and techniques for various endoscopic interventions for unilateral and bilateral vocal fold paralysis will be discussed here.