Common causes of unilateral VFP include iatrogenic (injury to recurrent laryngeal nerve (RLN) or vagus nerve during cardiothoracic or neck surgeries), idiopathic, and birth trauma. Common causes of bilateral VFP include idiopathic, neurologic (such as Arnold-Chiari malformation), and birth trauma (especially with forceps delivery). Unilateral VFP, on the other hand, usually presents with abnormal cry or feeding difficulty, in addition to stridor. Bilateral VFP often presents with severe airway obstruction such as stridor or respiratory distress, with up to 73% requiring tracheostomy. It can either be bilateral or unilateral, with reported incidence of about 50% each. IntroductionĬongenital vocal fold paralysis (VFP) is an important cause of respiratory compromise in infants. We describe a rare case of a cervical neuroblastoma presenting with unilateral VFP that was detected only on imaging, thus highlighting its value and importance. Therefore, unless an obvious cause of unilateral VFP is present (such as cardiac surgery or birth trauma), routine imaging of the brain, neck, and mediastinum should be performed for congenital unilateral VFP. While many of the unilateral VFP cases are idiopathic, the cause may occasionally be more sinister in nature, such as tumors. It can either be unilateral or bilateral, while imaging is routinely performed for bilateral VFP to evaluate for potential neurological causes, and such a practice may not be routine for unilateral VFP.

Congenital vocal fold paralysis (VFP) is an important cause of respiratory compromise in infants.

Skull imaging