[Inspiratory stridor due to vocal cord paralysis in children with myelomeningocele and hydrocephalus].

Inspiratory stridor in combination with myelomeningocele and increased intracranial pressure is caused by bilateral vocal cord paralysis in children with Arnold-Chiari-deformation. The diagnosis of bilateral vocal cord paralysis can be established by direct laryngoscopy performed without general anesthesia. As emergency measures naso-tracheal intubation, tracheostomy and immediate ventricular puncture are recommended. Reduction of intracranial pressure has always to be performed within 24 hours. The bilateral vocal cord paralysis is totally reversible if the inracranial pressure is decreased timely. The bilateral vocal cord paralysis becomes irreversible when degeneration of the nucleus ambiguus occurs secondary to peripheral lesions of the nervus vagus.