Injection Laryngoplasty for the Treatment of Type 1 Laryngeal Clefts: A Single Institution Experience. (July 2021)

• Record Type: Journal Article
• Authors: Al-Alawneh, Mohammad; Caballero, Ladd; DeBroux, Elijah; Herr, Michael J.; Petro, Amy Claire; Thompson, Jerome; McLevy, Jennifer; Wood, Joshua; Mamidala, Madhu; Sheyn, Anthony
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 130:Number 7(2021)
• Page Start: 775
• Page End: 780
• Publication Date: 2021-07
• Subjects: laryngopharyngeal reflux -- injection laryngoplasty -- pediatric otolaryngology -- laryngeal cleft; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489420973237
• Languages: English
• ISSNs: 0003-4894

Abstract

Objective: Standards for treatment of laryngeal clefts remain poorly defined. There are no large case series that report the efficacy of injection laryngoplasty (IL) in the treatment of pediatric Type 1 laryngeal clefts (LC-1). The objective of this study is to measure the effect of IL in young children with LC-1. Methods: A retrospective case series of 130 patients was completed over 3 years at a at a single institution included patients aged 1 month to 8 years, diagnosed with aspiration and penetration issues during swallowing based on a Videofluoroscopic Swallow Study (VFSS). Patients underwent surgical evaluation and intervention using carboxymethylcellulose gel injection. Collected data points included age in months at time of first injection, gender, race, pre- and post-operation VFSS scores, number of injections, co-morbidities and post-operative complications. VFSS scores were evaluated pre- and post-operatively to assess efficacy of intervention. A secondary outcome was efficacy in patients with aspiration compared to those with penetration alone. Results: This study included 77 male and 53 female patients. Sixty-two patients (48%) demonstrated a significant post-operative improvement in their swallowing function ( P < .05). There were no statistical differences in age, number of injections, or the volume of the first injection. Patients that showed a post-operative improvement in swallowing function were on average 5 months older and had more severe aspiration and penetration compared to those who did not demonstrate a post-operative benefit and underwent less injections. The volume of injection did not appear to play a role in the success rate. Conclusion: Injecting the inter-arytenoid area in patients with LC-1 appears to confer some benefit to close to half of our patient population. Successful procedures seemed to occur in patients with more severe aspiration and penetration and older age.