Laryngeal reinnervation for paediatric vocal cord palsy: a systematic review

Hoey, Andrew W; Hall, Andrew; Butler, Colin R.; Frauenfelder, Claire; Wyatt, Michelle

doi:10.1007/s00405-022-07471-y

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…The ansa cervicalis‐to‐RLN, the hypoglossal‐to‐RLN, or the phrenic‐to‐RLN anastomoses are the main unilateral 80,81 or bilateral 82,83 laryngeal reinnervation approaches to restore the posterior cricoarytenoid muscle function and the vocal cord abduction 80‐83 . Most case‐series of laryngeal recurrent reinnervation for BVFP were reported in children 82 . In adults, the first case of phrenic‐to‐RLN anastomosis was reported in 1983 by Crumley who showed an improvement of glottic diameter but no active arytenoid movement 83 .…”

Section: Resultsmentioning

confidence: 99%

“…[80][81][82][83] Most caseseries of laryngeal recurrent reinnervation for BVFP were reported in children. 82 In adults, the first case of phrenicto-RLN anastomosis was reported in 1983 by Crumley who showed an improvement of glottic diameter but no active arytenoid movement. 83 Variations on the phrenic technique were described involving an extralaryngeal neurorrhaphy between the main trunk of the RLN and concomitant intralaryngeal transection of the adductor branches of the recurrent nerve.…”

Section: Laryngeal Pacing and Reinnervationmentioning

confidence: 99%

“…The ansa cervicalis-to-RLN, the hypoglossal-to-RLN, or the phrenic-to-RLN anastomoses are the main unilateral 80,81 or bilateral 82,83 laryngeal reinnervation approaches to restore the posterior cricoarytenoid muscle function and the vocal cord abduction. [80][81][82][83] Most caseseries of laryngeal recurrent reinnervation for BVFP were reported in children. 82 In adults, the first case of phrenicto-RLN anastomosis was reported in 1983 by Crumley who showed an improvement of glottic diameter but no active arytenoid movement.…”

Section: Laryngeal Pacing and Reinnervationmentioning

confidence: 99%

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Management of Bilateral Vocal Fold Paralysis: A Systematic Review

Lechien,

Hans,

Mau

2023

Otolaryngol.--head neck surg.

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ObjectiveTo review the current literature about epidemiology, etiologies and surgical management of bilateral vocal fold paralysis (BVFP).Data SourcesPubMED, Scopus, and Cochrane Library.Review MethodsA systematic review of the literature on epidemiology, etiologies, and management of adult patients with BVFP was conducted through preferred reporting items for systematic reviews and meta‐analyses statements by 2 investigators.ResultsOf the 360 identified papers, 245 were screened, and of these 55 were considered for review. The majority (76.6%) of BVFP cases are iatrogenic. BVFP requires immediate tracheotomy in 36.2% of cases. Laterofixation of the vocal fold was described in 9 studies and is a cost‐effective alternative procedure to tracheotomy while awaiting potential recovery. Unilateral and bilateral posterior transverse cordotomy outcomes were reported in 9 and 7 studies, respectively. Both approaches are associated with a 95.1% decannulation rate, adequate airway volume, but voice quality worsening. Unilateral/bilateral partial arytenoidectomy data were described in 4 studies, which reported lower decannulation rate (83%) and better voice quality outcome than cordotomy. Revision rates and complications vary across studies, with complications mainly involving edema, granuloma, fibrosis, and scarring. Selective posterior cricoarytenoid reinnervation is being performed by more surgeons and should be a promising addition to the BVFP surgical armamentarium.ConclusionDepending on techniques, the management of BVFP may be associated with several degrees of airway improvements while worsened or unchanged voice quality. The heterogeneity between studies, the lack of large‐cohort controlled randomized studies and the confusion with posterior glottic stenosis limit the draw of clear conclusion about the superiority of some techniques over others.

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Section: Resultsmentioning

confidence: 99%

Section: Laryngeal Pacing and Reinnervationmentioning

confidence: 99%

Section: Laryngeal Pacing and Reinnervationmentioning

confidence: 99%

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Management of Bilateral Vocal Fold Paralysis: A Systematic Review

Lechien,

Hans,

Mau

2023

Otolaryngol.--head neck surg.

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“…The most common iatrogenic origins concern surgeries performed on/near the laryngeal recurrent nerve path. Pediatric thyroidectomy, esophagectomy, or heart and pulmonary vessel surgeries are the most prevalent procedures associated with a risk of PBVCP [4,15,16]. The etiologies of BVCP substantially vary from children to adults.…”

Section: Etiologiesmentioning

confidence: 99%

Management of Pediatric Bilateral Vocal Fold Paralysis: A State-of-the-Art Review of Etiologies, Diagnosis, and Treatments

Lechien

2024

Children

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Objective: This paper reviews the current literature about epidemiology, etiologies, diagnosis, and management of pediatric bilateral vocal fold paralysis (PBVFP). Methods: According to PRISMA statements, a narrative review of the current literature was conducted through the PubMed, Scopus, and Cochrane Library databases about the epidemiology, etiologies, diagnosis, and management of PBVFP. Results: PBVCP is the second most common congenital laryngeal anomaly in the pediatric population, accounting for 10% to 20% of pediatric laryngeal conditions. PBVCP is related to idiopathic (42.2%), congenital (19.7%), and neurological (16.9%) conditions. A tracheotomy is required in 60% of cases regarding stridor and dyspnea, which are the most prevalent symptoms. The diagnosis is based on the etiological features, clinical presentation, laryngoscopic findings, and objective examinations. Laryngeal electromyography may be used to support the diagnosis in difficult cases, but its reliability depends on the practitioner’s experience. The primary differential diagnosis is posterior glottis stenosis, which needs to be excluded regarding therapeutic and management differences with PBVCP. Transient surgical procedures consist of tracheotomy or laterofixation of the vocal fold. Current permanent procedures include uni- or bilateral partial arytenoidectomy, posterior transverse cordotomy, cricoid splits, and laryngeal selective reinnervation. There is no evidence of the superiority of some procedures over others. Conclusions: PBVCP is the second most common laryngeal disorder in the pediatric population. Diagnosis is based on etiological and clinical findings and may require the use of laryngeal electromyography. Therapeutic management may involve several transient or permanent surgical procedures that are associated with overall subjective improvements in symptoms, laryngeal findings, and low complication rates.

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