Pseudolaryngeal Paralysis: A Postintubation Complication

Abstract

Seven patients in the pediatric age group who had severe posterior glottic stenosis are reported. All of these patients had been misdiagnosed as having bilateral vocal cord paralysis because of errors in observing the actual findings in the larynx. On cursory examination of the larynx, the findings resembled vocal cord paralysis, thus the name “pseudolaryngeal paralysis” was given to this disease entity. This paper describes in some detail the case histories, the endolaryngeal findings, and the therapy which was instituted and followed. The difficulties in managing this problem are also reviewed. Three of the seven patients were decannulated, two with persistent stress stridor and reduced exercise tolerance. Four other patients have improved, but are still in the process of being treated. The success of the therapy appears to be dependent on the severity of the scarring, whether there was fibrosis of the interarytenoideus muscle, and whether the cricoarytenoid joints were involved. It is hoped that by reporting this difficult problem, a more rapid and successful form of management will be developed.