Abstract
There have been very few reports on recurrent nerve paralysis in children in Japan. In the present paper, clinical findings, etiology and managements of recurrent nerve paralysis in children are discussed based on the experiences on 24 cases (11 males and 13 females) who were seen at the author's clinic during the last 10 years from 1970 to 1979.
In most of the cases, recurrent nerve paralysis occurred within one month after birth. Bilateral paralysis was seen in 5 cases, while the remaining 19 had unilateral paralysis. Diagnosis was made through laryngeal examinations by means of either direct laryngoscopy or laryngofiberscopy. Symptoms consisted of stridor, various degrees of dyspnea, weak cry and hoarseness.
It was most characteristic for recurrent nerve paralysis in infant that respiratory distress was frequently observed. Etiologies of paralysis were: cardiovascular diseases in 5 cases (ventricular septal defect, 4; myocarditis, 1), surgery for congenital lesions in 5 cases (esophageal lesion, 2; cardiovascular lesion, 2; lymphangioma of the neck, 1) and the pressure of a neck tumor in 1 (thyroglossal duct cyst). In 1 case, meningomyelocele associated with hydrocephalus was considered to be the cause of paralysis. The remaining 12 cases were considered to be idiopathic in origin.
For the relief of respiratory distress, intubation was necessitated in 2 cases, and tracheotomy was done in 1 case. Respiratory distress disappeared within six months in the vast majority of the cases. Hoarseness and weak cry also disappeared or improved within a few months.
