Paediatric Bilateral Vocal Cord Paralysis: Our Experience

Scatolini, María Laura; Rodríguez, Hugo; Pérez, Cinthia Giselle; Cocciaglia, Alejandro; Botto, Hugo; Nieto, Mary; Bordino, Lucas

doi:10.1016/j.otoeng.2017.10.007

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…Tracheotomy was the standard of care in the past for children with BVCP [1,9,[20][21][22]. In most national otolaryngology training programs, tracheotomy can be performed by otolaryngologists and head and neck surgeons without a fellowship in pediatric laryngology, improving the child's airway with BVCP and protecting the lungs from aspiration [1].…”

Section: Transient Proceduresmentioning

confidence: 99%

“…In addition, tracheotomy is important to avoid prolonged intubation and related sedation. Among tracheotomized children, 54% to 77% of cases may be decannulated in the weeks/months following the surgical procedure [4,9,[20][21][22]. A tracheotomy is a simple procedure, but it involves a significant burden of care for families and a risk of life-threatening complications, including granulomas, cutaneous lesions, skin infections, cannula obstruction, or accidental decannulation [23][24][25].…”

Section: Transient Proceduresmentioning

confidence: 99%

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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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Section: Transient Proceduresmentioning

confidence: 99%

Section: Transient Proceduresmentioning

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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“…Exclusion criteria included (1) letters, quizzes, or other review articles; (2) studies that reviewed only unilateral vocal fold paralysis; and (3) articles in which patients who underwent tracheostomy or not, adult versus pediatric patients, or unilateral vocal fold paralysis and BVFP cases could not be distinguished.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…Pediatric BVFP is most commonly iatrogenic or idiopathic in origin, with a favorable outcome occurring in the majority of such cases. [1][2][3] In a long-term study of 102 pediatric patients with vocal cord paralysis, 1 28 were identified with idiopathic vocal cord paralysis, of which 18 (64%) recovered within a range of 6 months to 11 years, while 26 had iatrogenic vocal fold paralysis, of which 12 (46%) recovered within 5 years. Historically, the rate of tracheostomy in neonates with BVFP has been reported to be 50% to 90%.…”

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confidence: 99%

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis

Thorpe

Kanotra

2020

Otolaryngol.--head neck surg.

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Objectives To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS. Data Sources PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) on September 9, 2019, with no date restriction. Review Methods Articles focusing on GWS or tracheostomy for initial management of BVFP were included. Articles describing patients who received no surgical intervention for BVFP were excluded. Results A total of 5989 articles were reviewed: 67 articles met inclusion criteria, and 240 patients were incorporated into the analysis. Patients who underwent primary GWS had an eventual tracheostomy rate of 6.0% (5/83). There were no statistically significant differences in the rate of tracheostomy, reoperation, or mortality among cricoid split, suture lateralization, and cordectomy/cordotomy. Patients who underwent primary tracheostomy failed to achieve decannulation in 36.9% (58/157) of cases. Decannulation was more likely in tracheostomized children who received GWS than those who did not (odds ratio, 6.336; P < .0001). Conclusions Most children who undergo primary GWS for BVFP avoid tracheostomy or reoperation. These data demonstrated no differences in surgical outcomes among the most common types of GWS for BVFP. For children who receive a tracheostomy as their first intervention for BVFP, GWS is associated with a significantly improved rate of decannulation.

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Management of Congenital Bilateral Abductor Vocal Cord Palsy for Tracheostomy in a Neonate

Abraham,

Osahan,

Ria

2023

Int. J. Res. Granthaalayah

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Paediatric Bilateral Vocal Cord Paralysis: Our Experience

Cited by 3 publications

References 15 publications

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

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

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis

Management of Congenital Bilateral Abductor Vocal Cord Palsy for Tracheostomy in a Neonate

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