Management of bilateral vocal fold paralysis in children

The wide range of aetiologies and the variable recovery rates mean standardized management of BVFP is not possible. L-EMG is not a reliable prognostic indicator of recovery. There is an emerging trend of suture lateralization to avoid tracheostomy. Extensive recent reviews have not identified a lateralization procedure that is superior overall. Small numbers of bilateral reinnervation have reported worldwide (n = 26) with some vocal cord recovery reported but relatively low decannulation rates at present (66%).