Vocal Fold Paralysis in Infants with Tracheoesophageal Fistula

Objectives: We describe the clinical characteristics atid matiagetnetit of vocal fold paralysis in infants who were bom with a tracheoesophageal fistula (TEF). Methods: This retrospective case series included all infants bom with TEFs who presented to our pediatrie otolaryngology unit and intensive care unit because of dyspnea or aphonia in the years 2005 and 2006, and who were found to have vocal fold paralysis. Results: Five boys and 1 girl were studied. One infant had stridor before TEF repair, and 5 after it. All children underwent flexible laryngotracheobronchoscopy and were treated in the pediatrie intensive care unit before diagnosis of the vocal fold paralysis (5 bilaterally and 1 utiilaterally) was made. The ages at diagnosis of paralysis ranged between 14 days and 14 months. Five infants required tracheostomy. Conclusions: Vocal fold paresis in infants is difficult to diagnose. The risk for recurrent laryngeal nerve injury associated with TEF and TEF repair should be emphasized in these children. We recommend that all newboms with TEF should be examined by an otolaryngologist before operation to confirm the mobility of the vocal folds and to rule out other associated airway malformations, and examined after operation if respiratory difficulties develop.