Endoscopic Arytenoid Abduction Lateropexy for the Treatment of Bilateral Vocal Cord Paralysis in Early Childhood: Case Report

Objectives: The treatment of bilateral vocal cord paralysis in early childhood is really challenging even now a days. One of the treatment options is endoscopic arytenoid abduction lateropexy; a reversible simple suture vocal cord lateralizing technique, the arytenoid cartilage is directly lateralized to normal abducted position. Authors introduce a case of a successfully treated toddler. Methods: The 2.5 years old boy had noisy breathing and dyspnea on exertion since delivery. Laryngo-tracheoscopy revealed bilateral vocal cord paralysis. Unilateral, left-sided endoscopic arytenoid abduction lateropexy was performed with supraglottic jet ventilation. Results: He remained intubated for 3 with an uncuffed tracheal tube. After extubation, no dyspnea or swallowing disorder occurred. During the follow-up laryngo-tracheoscopies, clinical growth charts and voice analysis showed satisfactory functional results. Conclusions: The endoscopic arytenoid abduction lateropexy is a minimally invasive, quick, reversible endoscopic glottis enlarging procedure, which might be a favorable solution for neonatal bilateral vocal cord paralysis even in early childhood. It provides immediately wide airway without any permanent damage to voice production.