Vocal cord immobility is the second most common abnormality of the larynx in the paediatric population. The team from New York aimed to characterise the long-term swallowing function in a cohort of patients with bilateral vocal cord immobility over a nine-year period. They conducted a retrospective review, and had complete data on 23 patients, which they followed up for a mean of 44 months. Data was collected regarding etiology, co-morbidities, and clinical examination findings. Nine children were considered developmentally delayed, with 14 children being of normal development. Surprisingly the mean age at diagnosis was 14 months. All children had follow-up flexible laryngoscopy and 48% were found to have return of vocal cord function. At diagnosis 60% of children were feeding orally, however despite half the children regaining function of the cords, the percentage of children feeding orally at follow-up was only 70%. They found there was no statistical correlation between VF mobility and swallowing function, but did find that co-morbidities are a significant predictor of long-term swallowing function. Of the nine patients with developmental delay, five (55%) required a gastrostomy tube at the time of presentation and six (67%) maintained a gastrostomy tube at most recent follow-up. Five of 14 patients with normal development (35%) required feeding tubes at the time of diagnosis while only two (14%) required a feeding tube at follow-up. Not surprisingly, neurologic deficit is a poor prognosis for return to oral intake. Paediatric patients with non-neurologic causes of BVFI are more likely to ultimately regain ability to feed orally and this information may benefit clinicians when advising parents on likely outcomes. 

Swallowing function in pediatric patients with bilateral vocal fold immobility.
Hsu J, Tibbetts KM, Wu D, et al.
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Louisa Ferguson

Evelina Childrens Hospital, London, UK.

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