Seventy-one cases of vocal cord palsy were seen over a 20-year period at the Hospital for Sick Children in Toronto. Forty-four percent of the cases had a bilateral vocal cord palsy. The etiology, management and outcome of all the cases are reviewed. Of the acquired vocal cord palsies, 64% recovered spontaneously. Only 29% of the congenital vocal cord palsies recovered spontaneously. An important consideration in the management of children with vocal cord palsy is the possibility of late spontaneous recovery or compensation. There should, therefore, be no hurry to perform surgical procedures to permanently lateralize the vocal cords or arytenoids.
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