Our early experience suggests that ansa-recurrent laryngeal nerve laryngeal reinnervation is a safe and effective treatment for unilateral vocal fold paralysis with symptomatic dysphonia and dysphagia in young children. The procedure has advantages compared with other treatments. This option should be discussed with parents when the paralysis is identified. The child should be observed for several years in the event that voice and swallowing symptoms from glottal incompetence do not improve.