Endoscopic management of bilateral vocal fold paralysis in newborns and infants

Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morb...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2017-06, Vol.97, p.13-17
Main Authors: Sedaghat, Sahba, M.D, Tapia, Mario, Fredes, Felipe, Rojas, Pablo
Format: Article
Language:English
Subjects:
Airway
Airway Obstruction - surgery
Bilateral vocal cord paralysis
Child
Cricoid Cartilage - surgery
Cricoid split
Endoscopy - adverse effects
Endoscopy - methods
Female
Humans
Infant
Infant, Newborn
Male
Otolaryngology
Pediatrics
Prospective Studies
Stridor
Tracheostomy - methods
Vocal cord immobility
Vocal Cord Paralysis - etiology
Vocal Cord Paralysis - surgery
Vocal Cords - surgery
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Description
Summary:Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS). The objective of this paper was to review our experience with EAPCS in newborns and infants. Prospective study involving patients undergoing endoscopic EAPCS for symptomatic BVCPAd. The primary outcomes were tracheostomy avoidance and resolution of airway symptoms. Three patients underwent EAPCS between January 2016 and December 2016. All patients stayed at least 7 days in the Intensive Care Unit (ICU) intubated. All patients presented complete resolution of their symptoms due to airway obstruction, without the need for tracheostomy. EAPCS is a novel and effective alternative to treat BVCPAd in patients under 1 year old. Our study is an initial experience; more cases are required to identify the real impact and benefits of this technique and to determine the proper selection of patients.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2017.03.021