Vocal cord paralysis and superior laryngeal nerve dysfunction in Reye's syndrome
J. W. Thompson, P. Rosenthal and F. S. Camilon Jr
Department of Surgery, Children's Hospital of Los Angeles, CA.
Bilateral vocal cord paralysis and absent laryngeal sensation are
previously unrecognized sequelae for Reye's syndrome, a severe acute
encephalopathy in children. Four patients were seen at varying periods
ranging from 2 weeks to 5 years after their diagnosis of an episode of
severe Reye's syndrome over a 20-year period at the Children's Hospital of
Los Angeles (Calif). All of the patients had bilateral true vocal cord
paralysis with absent laryngeal sensitivity that was documented at
endoscopy. As many as 50% of survivors of severe Reye's syndrome have
breathy voices or aphonia. It is suggested that some of these children may
have vocal cord dysfunction that is not the result of intubation, and are
at risk for aspiration and its dangerous sequelae. A vagal nuclear injury
is theorized to explain the sensory motor dysfunction of the larynx in
these children.