Prognosis of congenital idiopathic abductor laryngeal paralysis with laryngeal electromyography.

OBJECTIVE

To assess if laryngeal electromyography could provide additional information in the prognosis of congenital bilateral idiopathic abductor vocal cord paralysis (abCBILP).

METHODS

We performed a retrospective review over a 23-year period (1995-2018) of all children younger than 13 years old in the Medical University of Innsbruck.

RESULTS

We identified five infants with abCBILP. Fiberoptic laryngeal endoscopy revealed bilateral vocal cord immobility in adduction without accompanying laryngeal findings. Tracheostomy rate was 100%. Tracheostomy was performed after minimum 3 weeks of non-improvement with continuous positive airway pressure treatment or intubation. In all patients, repeated laryngeal electromyography revealed volitional activity. All patients showed excellent full late recovery in the second quinquennium of life.

CONCLUSION

Presence of volitional activity in laryngeal electromyography could identify patients with excellent prognosis. Prospective laryngeal electromyography studies are required in more patients with abCBILP in order to document laryngeal electromyography findings also by patients with poor late recovery. Patients with poor prognosis could be selected for early laryngeal intervention to avoid tracheostomy-dependent issues.

LEVEL OF EVIDENCE: 4 Laryngoscope, 130:E252-E257, 2020.