Endoscopic management of bilateral vocal fold paralysis in newborns and infants. (June 2017)

• Record Type: Journal Article
• Authors: Sedaghat, Sahba; Tapia, Mario; Fredes, Felipe; Rojas, Pablo
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 97(2017:Jun.)
• Page Start: 13
• Page End: 17
• Publication Date: 2017-06
• Subjects: Bilateral vocal cord paralysis -- Cricoid split -- Stridor -- Vocal cord immobility -- Airway; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2017.03.021
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Introduction: 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. Methods: Prospective study involving patients undergoing endoscopic EAPCS for symptomatic BVCPAd. The primary outcomes were tracheostomy avoidance and resolution of airway symptoms. Results: 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. Conclusion: 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.