Unilateral vocal fold paralysis in children has many different etiologies that can result in difficulties with breathing, swallowing, or phonation. Depending on the severity of symptoms, treatment modalities range from non-surgical interventions, to temporary surgical procedures, or more permanent surgical options. Laryngeal reinnervation has been demonstrated as an appropriate treatment option for children with permanent laryngeal nerve damage and persistent symptoms, but it still not widely performed among pediatric otolaryngologists. In this case, we present a 6 year-old female patient who developed unilateral vocal fold paralysis from a cardiac procedure as an infant, and she subsequently underwent laryngeal reinnervation with ansa cervicalis-to-recurrent laryngeal nerve (ANSA-RLN) anastomosis. The patient tolerated the procedure well with no peri-operative complications and demonstrated symptomatic improvement in voice quality and swallowing at her 3 month follow-up appointment. The goal of this case is to demonstrate the steps of the laryngeal reinnervation procedure and acknowledge its importance as a treatment option for unilateral vocal fold paralysis in pediatric patients.
Cori N Walker MD1, Christopher Blake Sullivan MD1, Sohit P Kanotra MD1
Department of 1Otolaryngology – Head and Neck Surgery
University of Iowa Hospitals and Clinics, Iowa City, IA, USA