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.