Idiopathic Laryngeal Paralysis Research Articles

Neurofilament light chain concentration does not correlate with disease status in Labrador Retrievers affected with idiopathic laryngeal paralysis.

The aim of this study was to investigate whether plasma neurofilament light chain (pNfL) concentration was altered in Labrador Retrievers with idiopathic laryngeal paralysis (ILP) compared to a control population. A secondary aim was to investigate relationships between age, height, weight, and body mass index in the populations studied. 123 dogs: 62 purebred Labrador Retrievers with ILP (ILP Cases) and 61 age-matched healthy medium- to large-breed dogs (Controls). Dogs, recruited from August 1, 2016, to March 1, 2022, were categorized as case or control based on a combination of physical exam, neurologic exam, and history. Blood plasma was collected, and pNfL concentration was measured. pNfL concentrations were compared between ILP Cases and Controls. Covariables including age, height, and weight were collected. Relationships between pNfL and covariables were analyzed within and between groups. In dogs where 2 plasma samples were available from differing time points, pNfL concentrations were measured to evaluate alterations over time. No significant difference in pNfL concentration was found between ILP Cases and Control (P = .36). pNfL concentrations had moderate negative correlations with weight and height in the Control group; other variables did not correlate with pNfL concentrations in ILP Case or Control groups. pNfL concentrations do not correlate with ILP disease status or duration in Labrador Retrievers. There is no evidence that pNfL levels are altered due to ILP disease duration or progression when compared with healthy controls. When evaluating pNfL concentrations in the dog, weight and height should be considered.

Comparison of immediate and short-term outcomes of cricoarytenoid and thyroarytenoid lateralization in dogs with idiopathic laryngeal paralysis.

To compare the immediate and short-term outcomes of thyroarytenoid lateralization (TAL) and cricoarytenoid lateralization (CAL) for the treatment of canine laryngeal paralysis in dogs. A prospective, clinical trial. Fourteen client-owned dogs referred to our hospital because of bilateral laryngeal paralysis. Dogs with confirmed laryngeal paralysis were randomly assigned to the CAL or TAL group. Video images of the rima glottidis obtained preoperatively, immediately postoperatively (t0), and 15 days postoperatively (t1) were digitized. The rima glottidis area was measured using image-analysis software. An increase in the rima glottidis area was expressed as a percentage of the preoperative area. The rima glottidis area increased by a mean of 152% at t0 and 127% at t1 for the TAL group and 205% at t0 and 199% at t1 for the CAL group compared with preoperative values. The increase in the rima glottidis area differed (P < .05) between the 2 groups at all postoperative time points. A reduction of the area occurred at t1 in both groups. There was no difference between t0 and t1 (P > .05) in the CAL group but there was a large difference (P < .05) in the TAL group. Cricoarytenoid lateralization and TAL were both effective for surgical abduction of the arytenoid cartilage. Although a reduction (P < .05) in the rima glottidis area occurred in the TAL group at t1, we observed no associated clinical signs. Cricoarytenoid lateralization and TAL result in good short-term outcomes in dogs with laryngeal paralysis.

Impact of COVID-19 on vocal cord mobility: a case series study

BackgroundThe World Health Organization (WHO) has declared the pandemic of COVID-19 infection in March 2020, most of cases presented with mild symptoms, and a significant number of cases showed variable neurological pictures. Vocal cord paralysis with no clear cause is termed as idiopathic vocal cord paralysis and supposed to be caused by viral infection. This is a case series study; data were collected prospectively from patients presented to the ENT clinic of Kasr Alainy (Cairo university) and Railway hospitals. Patients presented with defective vocal cord movement with concurrently or recently passed COVID-19 infection were reported from March 2020 to April 2021.ResultsAuthors have reported 6 cases of vocal cord paralysis mainly unilateral due to COVID-19 infection as an only clear cause within 14 months. Age ranges from 39 to 69 years, 2 males and 4 females. Patients presented with different clinical scenarios. Follow-up of the cases showed spontaneous recovery in 5 cases and one case underwent cord medialization.ConclusionViral infection could be an underlying cause of idiopathic laryngeal cord paralysis; in the new era of the COVID-19 pandemic, physicians all over the world noticed variable neurological pictures; in this study, we presented 6 cases of vocal cord paralysis mainly unilateral supposed to be due to COVID-19 infection; all cases showed spontaneous recovery apart from one case that needed medialization of the cord.

Effect of Metoclopramide on the Incidence of Early Postoperative Aspiration Pneumonia in Dogs with Acquired Idiopathic Laryngeal Paralysis.

Evaluate the effect of a perioperative intravenous continuous rate infusion (CRI) of metoclopramide on the incidence of aspiration pneumonia in the short term postoperative period in dogs undergoing unilateral arytenoid lateralization. Prospective, randomized, multi-center clinical trial. 61 client-owned dogs with idiopathic laryngeal paralysis and normal preoperative thoracic radiographs. All dogs underwent unilateral arytenoid lateralization with a uniform anesthetic, analgesic, and management protocol. Dogs in the treatment group received an intravenous CRI of metoclopramide for 24 hours perioperative. All dogs were assessed for clinical signs of aspiration pneumonia based on the results of physical examination and owner interview up to the point of suture removal (10-14 days postoperative). Any dog with suspected aspiration pneumonia had thoracic radiographs performed. Six dogs developed aspiration pneumonia in the short term postoperative period (2/28 control dogs and 4/33 treated dogs), accounting for an overall frequency of 10% with no significant difference between control and treated dogs. No variables measured in the study were significantly different between control and treated dogs. Perioperative metoclopramide, at the doses used in this study, did not affect the incidence of aspiration pneumonia in the short term postoperative period in dogs with idiopathic laryngeal paralysis undergoing unilateral arytenoid lateralization.

Idiopathic Canine Laryngeal Paralysis as One Sign of a Diffuse Polyneuropathy: An Observational Study of 90 Cases (2007-2013).

To determine survival and incidence of complications in dogs with idiopathic laryngeal paralysis (ILP) and concurrent neurologic signs. Observational study. Dogs (n = 90) with ILP. Medical records (January 2007-June 2013) of dogs with ILP were reviewed. Neurologic comorbidities, including pelvic limb neurologic abnormalities and esophageal abnormalities were identified. Using medical record information and client interviews, the relationship between these comorbidities and postoperative survival (primary outcome measure) and postoperative complications (secondary outcome measure) was identified. Dogs that had surgical correction of ILP had a 2.6-fold reduction in the hazard of death throughout the study period (HR = 2.6; 95% CI: 1.34-4.84, P = .006). Owner assessed patient quality of life (10-point scale) increased by an average of 4.1 ± 1.4 units immediately postoperatively, and 4.9 ± 0.9 units until death or followup compared with preoperative values. Thirty-five of 72 dogs available for followup had evidence of diffuse neurologic comorbidities. Overall complication rate for dogs with neurologic comorbidities was 74%, compared with 32% for dogs without neurologic comorbidities. Presence of any neurologic comorbidity was associated with a significantly greater odds of any complication (OR = 4.04; 95% CI: 1.25-13.90, P = .019) as well as recurring complications (OR = 8.00; 95% CI: 1.49-54.38; P = .015). Surgical correction of ILP was positively associated with survival, and dogs with neurologic comorbidities were at greater risk for developing postoperative complications.

Evaluation of Pharyngeal Function in Dogs with Laryngeal Paralysis Before and After Unilateral Arytenoid Lateralization.

To evaluate pharyngeal and laryngeal function using esophagography, topical pharyngeal/laryngeal sensitivity testing, and electromyography (EMG) in normal and dogs with idiopathic laryngeal paralysis (ILP) before and after unilateral arytenoid lateralization. Prospective controlled cohort study. Dogs with laryngeal paralysis (ILP; n = 8) and age/breed-matched (AB, n = 8) and young breed-matched dogs (B, n = 8) were recruited. Evaluation consisted of esophagography, topical pharyngeal/laryngeal sensitivity testing, and electrodiagnostic testing. Esophagography was performed with liquid and canned phases. Pharyngeal and laryngeal sensitivity was tested by applying a cotton-tipped applicator to the mucosa of pharynx/larynx at anesthetic induction. In all dogs, electrophysiological testing included EMG, direct evoked muscle potentials, motor nerve conduction velocities, and F wave testing. These were performed in the thoracic/pelvic limbs, extrinsic laryngeal muscles, epaxial, and masticatory muscles. Topical pharyngeal and laryngeal sensitivity testing was decreased in LP dogs compared with age-matched healthy control dogs. Esophagram showed dysmotility in the cranial and caudal esophagus. Gastroesophageal reflux was significantly higher in ILP dogs compared with the other 2 groups (P < .03). In all affected dogs, EMG abnormalities were limited to the interosseous muscles of both pelvic and thoracic limbs bilaterally. Dogs with ILP not only have recurrent laryngeal nerve (RLN) and pararecurrent laryngeal nerve (pRLN) dysfunction, but may also have concurrent cranial laryngeal nerve dysfunction.

Atypical Presentation of a Common Disease: Shingles of the Larynx

Herpes zoster is a neurocutaneous disease resulting from the reactivation of endogenous varicella-zoster virus (VZV) in dorsal sensory or cranial nerve ganglia. Rarely, this infection manifests without the characteristic dermatomal rash, a condition termed zoster sine herpete. Viral spreading of herpes zoster in the head and neck may manifest as various signs and symptoms because of the multiple possible combinations of cranial neuropathies. With only six cases reported in the English literature up to now, isolated neuropathies of the vagus nerve in the absence of cutaneous lesions tend to be misdiagnosed as idiopathic laryngeal paralysis. We report a case of herpes zoster of the larynx in an 80-year-old man presenting with sore throat, dysphagia, and hoarseness. Endoscopic examination revealed unilateral vocal fold paralysis, pooling of secretions, and mucosal vesicles of the hemilarynx. After the diagnosis of VZV infection with polymerase chain reaction (PCR) testing, the patient was treated with valacyclovir and corticosteroids, leading to complete recovery after 2 months. Herpes zoster of the larynx is an uncommon condition that should be included in the differential diagnosis of laryngeal paralysis of idiopathic cause. We recommend performing a thorough examination of the pharyngolaryngeal structures and ordering PCR testing as the diagnostic method of choice.

Spontaneous recovery of bilateral congenital idiopathic laryngeal paralysis: Systematic non-meta-analytical review

ObjectivesTo systematically review the frequency and time to spontaneous recovery in pediatric patients with bilateral congenital idiopathic laryngeal paralysis (BCILP). MethodsThe databases of Medline, EMBASE, Scopus, CINAHL, Cochrane Library and Proquest Dissertations were searched for English language articles reporting on laryngeal paralysis in pediatric patients. A bibliography search of the selected studies was done to identify additional articles. We included prospective or retrospective case-series studies of children and neonates diagnosed with BCILP at age <60 days and confirmed by direct laryngoscopy, with sufficient follow up and objective assessment for recovery.Two authors independently extracted the data and assessed the quality of each study. Discrepancies were resolved by consensus and adjudication by a third author. ResultsOf the 4229 articles identified by the search, only one study met our inclusion criteria. The study was a retrospective case series, and was of low quality. The mean age at diagnosis was fourteen days. Sixty-five percent of the patients recovered spontaneously, and the mean time to recovery was twenty-five months. Tracheostomy was performed in 71% of the patients. ConclusionsThe available literature is of low quality and provides weak evidence on the natural history of BCILP in pediatric population.

Less Invasive Unilateral Arytenoid Lateralization: A Modified Technique for Treatment of Idiopathic Laryngeal Paralysis in Dogs: Technique Description and Outcome

To (1) describe a modification of conventional unilateral cricoarytenoid lateralization (UCAL), called less-invasive unilateral cricoarytenoid lateralization (LI-UCAL) for treatment of idiopathic laryngeal paralysis (LP); (2) report clinical outcome of LI-UCAL; and (3) describe the effect of early discharge after surgery. Retrospective clinical study. Dogs (n = 22). Medical records (January 2009 to October 2011) of dogs diagnosed with idiopathic LP that had LI-UCAL were reviewed. Signalment, clinical signs, laboratory tests, imaging, concurrent medical conditions, information from the anesthesia record, and hospitalization time were documented. Follow-up was obtained by direct examination, questionnaire, and review of medical records from referring veterinarians. Dogs included in the study had variable degrees and duration of respiratory distress before surgery. Median surgery time was 32 minutes. Median hospitalization was 6 hours, and median follow-up was 427 days. Long-term respiratory function, as reported by owners at last follow-up, improved in 95.5% of dogs after surgery; exercise tolerance improved by 90%. Major complications included death secondary to aspiration pneumonia (9%), aspiration pneumonia from which dogs recovered within 3 days after administration of antimicrobials (9%), and development of right-sided laryngeal collapse that required right sided LI-UCAL (4.5%). At long-term follow-up, 95.5% of owners were satisfied with the surgical outcome. LI-UCAL is a feasible surgical technique and resulted in improvement of clinical signs related to LP. Calm recoveries without adverse effects such as respiratory distress were associated with early discharge. LI-UCAL could be considered an alternative to conventional UCAL.

Video-assisted unilateral cricoarytenoid laryngoplasty in 14 dogs with bilateral idiopathic laryngeal paralysis

Background: Unilateral cricoarytenoid laryngoplasty is commonly performed for treatment of idiopathic laryngeal paralysis in dogs. Determination of the appropriate tension applied to the suture can be difficult, particularly for the novice surgeon.Objective: To describe a technique for video-assisted unilateral cricoarytenoid laryngoplasty (VAUCAL) and to report short-term outcome in dogs undergoing VAUCAL.Animals and methods: Dogs (n = 14) with bilateral idiopathic laryngeal paralysis undergoing VAUCAL between August 2011 and May 2013 were evaluated. A cricoarytenoid suture was tensioned under video observation of the rima glottidis using a 5-mm rigid endoscope. Real-time visualization of arytenoid abduction during suture tensioning, and final arytenoid position were assessed. Requirement for additional intravenous anesthestic, intra- and post-operative complications and short-term outcomes were documented.Results: Adequate, real-time visualization of the larynx during tensioning of the cricoarytenoid suture was accomplished in 13/14 dogs. Additional intravenous anesthesia was required in 5/14 dogs to facilitate reintubation. Final arytenoid position was considered inadequate in two dogs on post-operative trans-oral laryngeal examination. Recurrence of clinical signs occurred in one dog three months following initial surgery. Owner outcome was deemed good (n = 8) or excellent (n = 6).Conclusions: VAUCAL is a feasible technique to permit direct real-time visualization of the larynx during tensioning of the cricoarytenoid suture, and enables assessment of final arytenoid position intra-operatively by the operating surgeon.Clinical importance: VAUCAL allows the operating surgeon to assess arytenoid abduction intra-operatively, at the time of knot placement. This technique may be particularly useful for the novice surgeon or surgeon in training.

Laryngeal paralysis in dogs: An update on recent knowledge

Laryngeal paralysis is the effect of an inability to abduct the arytenoid cartilages during inspiration, resulting in respiratory signs consistent with partial airway obstruction. The aetiology of the disease can be congenital (hereditary laryngeal paralysis or congenital polyneuropathy), or acquired (trauma, neoplasia, polyneuropathy, endocrinopathy). The most common form of acquired laryngeal paralysis (LP) is typically seen in old, large breed dogs and is a clinical manifestation of a generalised peripheral polyneuropathy recently referred to as geriatric onset laryngeal paralysis polyneuropathy. Diagnosing LP based on clinical signs, breed and history has a very high sensitivity (90%) and can be confirmed bylaryngeal inspection. Prognosis after surgical correction depends on the aetiology: traumatic cases have a good prognosis, whereas tumour-induced or polyneuropathy-induced LP has a guarded prognosis. Acquired idiopathic LP is a slow progressive disease, with dogs reaching median survival times of 3-5 years after surgical correction.

Bilateral Ventriculocordectomy via Ventral Laryngotomy for Idiopathic Laryngeal Paralysis in 88 Dogs

Bilateral ventriculocordectomy through a ventral median laryngotomy was performed for the treatment of idiopathic laryngeal paralysis in 88 dogs. The purpose of this retrospective analysis was to provide long-term follow-up for a large number of dogs surgically managed with this technique. A combination of medical record and completed client questionnaire information provided short-term (14 days) follow-up for 88 dogs and long-term (>6 mo) follow-up for 42 dogs. Major short-term postoperative complications were identified in 3 of 88 (3.4%) patients. Major long-term complications were identified in 3 of 42 (7.1%) patients. The results of surgery were considered to be very satisfactory in 93% and unsatisfactory in 7%. Three dogs in this series developed aspiration pneumonia. Bilateral ventriculocordectomy through a ventral median laryngotomy is associated with a low incidence of both short- and long-term complications. Due to the ease of this procedure, the minimal surgical trauma to the patient, and the satisfactory results, this surgery should be considered an option for the treatment of idiopathic laryngeal paralysis in the dog.

Intraoperative Evaluation of the Larynx Following Unilateral Arytenoid Lateralization for Acquired Idiopathic Laryngeal Paralysis in Dogs

The purposes of this study were to describe a modified surgical technique in which intraoperative extubation was performed to evaluate abduction of the arytenoid cartilage prior to tying the suture and to assess outcome and complication rates associated with this procedure. Medical records from 30 client-owned dogs with acquired idiopathic laryngeal paralysis were retrospectively reviewed. All clients were contacted by telephone to obtain follow-up information regarding their dog. Six of the 30 surgeries required additional dissection (primarily around the craniodorsal aspect of the cricoarytenoid joint) after the initial intraoperative laryngeal examination. The procedures in 29 of the 30 dogs were deemed a success by the owners. Three (10%) dogs developed postoperative aspiration pneumonia. One of these dogs required long-term antibiotic therapy. Twenty-nine dogs returned to normal activity, and none of the dogs had any exercise intolerance associated with respiratory difficulties. Three owners reported that their dogs were able to swim, and one dog hunted postoperatively. Results of this study suggest that intraoperative laryngeal examination may help limit postoperative complications by allowing for direct, intraoral visualization of the arytenoid cartilage. This enables a surgeon to modify the soft tissue dissection around the cricoarytenoid joint to ensure that adequate abduction is apparent.

Esophageal Dysfunction in Dogs with Idiopathic Laryngeal Paralysis: A Controlled Cohort Study

To compare esophageal function in dogs with idiopathic laryngeal paralysis (ILP) to age and breed matched controls; to determine if dysfunction is associated with aspiration pneumonia over 1 year; and to compare clinical neurologic examination of dogs with ILP at enrollment and at 1 year. Prospective controlled cohort study. Dogs with ILP (n=32) and 34 age and breed matched healthy dogs. Mean esophageal score was determined for each phase of 3 phase esophagrams, analyzed blindly. After unilateral cricoarytenoid laryngoplasty, dogs with ILP were reexamined (including thoracic radiography) at 1, 3, 6, and 12 months. Neurologic status was recorded at enrollment, 6 and 12 months. Esophagram scores in dogs with ILP were significantly higher in each phase compared with controls, most notably with liquid (P<.0001). Dysfunction was more pronounced in the cervical and cranial thoracic esophagus. Five dogs that had aspiration pneumonia during the study had significantly higher esophagram scores than dogs that did not develop aspiration pneumonia (P<.02). Ten (31%) ILP dogs had generalized neurologic signs on enrollment and all ILP dogs developed neurologic signs by 1 year (P<.0001). Conclusions- Dogs with ILP also have esophageal dysfunction. Postoperative aspiration pneumonia is more likely in dogs with higher esophagram scores. Dogs with ILP will most likely develop generalized neuropathy over the course of 1 year. Esophagrams and neurologic examinations should be performed on all dogs with ILP.

ESOPHAGEAL DYSFUNCTION IN DOGS WITH IDIOPATHIC LARYNGEAL PARALYSIS: A CONTROLLED COHORT STUDY

Objectives: To compare esophageal function in dogs with idiopathic laryngeal paralysis (ILP) to age- and breed-matched controls; to determine if dysfunction is associated with aspiration pneumonia over one year; and to compare clinical neurologic examination of dogs with ILP at enrollment and one year. Study Design: Prospective controlled cohort study Animals or Sample Population: 32 dogs with ILP, and 34 age- and breed-matched healthy dogs. Methods: Three-phase esophagrams were performed on all dogs. Blinded analyses of the esophagrams were performed, and the mean esophageal score determined in each phase. Following unilateral crico-arytenoid laryngoplasty, dogs with ILP were re-examined including thoracic radiography at 1, 3, 6 and 12 months. Neurologic status was recorded at enrollment, 6 and 12 months. Results: Esophagram scores in dogs with ILP were significantly higher in each phase compared to the controls, most notably with liquid (P&amp;lt;.0001). Dysfunction was more pronounced in the cervical and cranial thoracic esophagus. The 5 dogs that experienced aspiration pneumonia during the study period had significantly higher esophagram scores than the dogs that did not develop aspiration pneumonia (P&amp;lt;0.02). Ten of the 32 (31%) dogs with ILP had generalized neurologic signs upon enrollment and all (100%) dogs developed neurologic signs over one year (P&amp;lt;.0001). Conclusions: Dogs with ILP also have esophageal dysfunction. Post-operative aspiration pneumonia is more likely in dogs with higher esophagram scores. Dogs with ILP will most likely develop generalized neuropathy over the course of a year. Clinical Relevance: Esophagrams and neurologic examinations should be performed on all dogs with ILP.

Bilateral Thyroarytenoid Cartilage Lateralization and Vocal Fold Excision with Mucosoplasty for Treatment of Idiopathic Laryngeal Paralysis: 67 Dogs (1998–2005)

To evaluate combined bilateral thyroarytenoid cartilage lateralization, vocal fold excision, and mucosoplasty technique (BTAL) through ventral median laryngotomy for treatment of laryngeal paralysis in dogs. Design- Retrospective study. Animals- Dogs (n=67) with laryngeal paralysis. Medical records were reviewed for dogs with idiopathic laryngeal paralysis that had BTAL between January 1998 and March 2005. Retrieved data included signalment, history, physical and laryngoscopic examination findings, clinicopathologic tests, and results of recheck examination findings. BTAL was performed by a single surgeon. Short-term (<6 months) follow-up information was available for 67 dogs and long-term (>12 months) for 40 dogs. Major postoperative complications were surgical failures (13; 7 short term, 6 long term) and aspiration pneumonia (1). Mean recurrence of clinical signs was at 19 weeks (range, 2-30 weeks). Minor complications occurred in 22 (33%) dogs including occasional coughing or gagging, stridorous breathing during exercise, panting, noisy or heavy breathing, and aspiration pneumonia (3 dogs) that did not require hospitalization. All owners reported an improved quality of life and had no regrets with surgical outcome. BTAL is seemingly an effective procedure for treatment of laryngeal paralysis. Clinical Relevance- BTAL is associated with a low incidence of aspiration pneumonia; however, there is substantial risk of recurrence of clinical signs associated with narrowing of the glottis. Consequently, unilateral arytenoid lateralization currently represents the accepted approach to the treatment of laryngeal paralysis.

Postoperative results of unilateral arytenoid lateralization for treatment of idiopathic laryngeal paralysis in dogs: 39 cases (1996–2002)

To evaluate postoperative results for dogs with idiopathic laryngeal paralysis that underwent unilateral arytenoid lateralization (UAL). Retrospective case series. 39 dogs with idiopathic laryngeal paralysis. Medical records were reviewed, and information on surgical technique, hospitalization time, postoperative treatment, and complications was obtained. Owners were contacted by telephone for additional information if necessary. In all dogs, UAL had been performed by a single surgeon who used a standard surgical technique. Long-term follow-up information was available for all 39 dogs; mean follow-up time was 29.6 months (range, 3 to 61 months). Seven (18%) dogs developed postoperative pneumonia, and 6 of the 7 recovered with treatment. Twenty-two of the 39 (56%) dogs had minor complications, including unresolved coughing or gagging, continued exercise intolerance, vomiting, and seroma formation. Owners of 35 of the 39 (90%) dogs reported an improvement in postoperative quality-of-life score. Median survival time was 12 months; only 1 dog was euthanized because of respiratory tract disease following surgery. Results suggest that UAL will improve quality of life in most dogs with idiopathic laryngeal paralysis. However, the complication rate is high, with postoperative pneumonia being the most important major complication. Minor complications were common but did not adversely affect owner-assigned quality-of-life scores in most dogs.

Acquired idiopathic laryngeal paralysis as a prominent feature of generalised neuromuscular disease in 39 dogs

A retrospective evaluation of 17 dogs treated surgically for idiopathic acquired laryngeal paralysis demonstrated a marked variability in outcome, with many dogs continuing to exhibit weakness and exercise tolerance. In...

Outcome of laryngeal paralysis in neonates: a long term retrospective study of 113 cases

Between 1985 and 1990, 113 children were diagnosed as having congenital vocal cord paralysis. Most of them were still being followed up in June 1994. Fifty two had bilateral paralysis, 61 had unilateral paralysis: 41 were on the left side and 20 on the right side. Forty two were idiopathic, 29 were associated with neurologic disorders, six were associated with heart malformations. Fifteen children were born after difficult delivery. Among the newborns with unilateral paralysis that occurred after an abnormal delivery, 73% recovered spontaneously; likewise 70% of the neurologic group and 74% of the idiopathic group recovered spontaneously. The prognosis of bilateral paralysis was worse with only 52% of spontaneous recovery in the neurologic disorders group and the idiopathic group. Seven percent of the children underwent a surgical procedure. They were all decanulated or extubated. In view of our experience the prognosis is poor for bilateral idiopathic laryngeal paralysis or those with neurological context.

Neurogenic laryngeal paralysis in the dog

Idiopathic laryngeal paralysis in dogs is now a frequently recognised disorder, particularly in certain breeds such as the Labrador retriever, Afghan hound and Irish setter. Since it occurs in the older animal, distinguishing the clinical signs and their significance from lower respiratory tract or cardiac disease can be challenging. At present little is known about its aetiology and therefore the treatment is directed at relieving the clinical signs. Recent work indicates that arytenoid cartilage lateralisation achieves the best results as a method of surgically correcting the laryngeal obstruction. However, it should be remembered that the potential benefits of surgery should be assessed for each individual, taking into account the presence of concurrent disease and lifestyle of the dog.