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Vocal fold medialization in children: injection laryngoplasty, thyroplasty, or nerve reinnervation?
Arch Otolaryngol Head Neck Surg. 2007 Aug; 133(8):767-71.AO

Abstract

OBJECTIVE

To review surgical interventions for pediatric unilateral vocal fold immobility (UVFI).

DESIGN

Retrospective medical chart review.

SETTING

Two tertiary academic centers.

PATIENTS

All children who underwent vocal fold medialization for dysphonia, with or without aspiration, from January 2004 to September 2006.

INTERVENTIONS

Injection laryngoplasty, ansa cervicalis-recurrent laryngeal nerve anastomosis, or thyroplasty.

MAIN OUTCOME MEASURES

Age, sex, intervention, etiology, time from onset of UVFI to surgery, subjective success in improving voice, subjective duration of improvement, and complications.

RESULTS

Twenty-seven procedures were performed in 15 patients (mean age, 10.6 years). Nineteen injection laryngoplasties, 3 thyroplasties (1 bilateral), 2 ansa cervicalis-recurrent laryngeal nerve reinnervation procedures, 1 adduction arytenoidopexy, and 1 cricothyroid joint subluxation were performed. Causes of UVFI included thoracic surgery in 6 cases (40%), prolonged intubation in 4 (26%), central nervous system neoplasm in 3 (20%), unknown etiology in 1 (7%), and anoxic brain injury in 1 (7%). The mean duration from onset of symptoms to treatment was 47 months. There was 1 surgical complication (postoperative aspiration pneumonia following thyroplasty while the patient was under local anesthesia). Parents reported a satisfactory outcome in all cases.

CONCLUSIONS

Injection laryngoplasty, thyroplasty, and nerve reinnervation can be performed in pediatric patients with good outcomes and an acceptable safety profile. This article describes the experiences of 2 institutions with phonosurgery for UVFI in children and provides insight into the advantages and disadvantages of each procedure. Prospective studies, with validated quality-of-life measurements, are needed to greater clarify the role of different types of phonosurgery in children with UVFI.

Authors+Show Affiliations

Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17709613

Citation

Sipp, J Andrew, et al. "Vocal Fold Medialization in Children: Injection Laryngoplasty, Thyroplasty, or Nerve Reinnervation?" Archives of Otolaryngology--head & Neck Surgery, vol. 133, no. 8, 2007, pp. 767-71.
Sipp JA, Kerschner JE, Braune N, et al. Vocal fold medialization in children: injection laryngoplasty, thyroplasty, or nerve reinnervation? Arch Otolaryngol Head Neck Surg. 2007;133(8):767-71.
Sipp, J. A., Kerschner, J. E., Braune, N., & Hartnick, C. J. (2007). Vocal fold medialization in children: injection laryngoplasty, thyroplasty, or nerve reinnervation? Archives of Otolaryngology--head & Neck Surgery, 133(8), 767-71.
Sipp JA, et al. Vocal Fold Medialization in Children: Injection Laryngoplasty, Thyroplasty, or Nerve Reinnervation. Arch Otolaryngol Head Neck Surg. 2007;133(8):767-71. PubMed PMID: 17709613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vocal fold medialization in children: injection laryngoplasty, thyroplasty, or nerve reinnervation? AU - Sipp,J Andrew, AU - Kerschner,Joseph E, AU - Braune,Nicole, AU - Hartnick,Christopher J, PY - 2007/8/22/pubmed PY - 2007/9/26/medline PY - 2007/8/22/entrez SP - 767 EP - 71 JF - Archives of otolaryngology--head & neck surgery JO - Arch Otolaryngol Head Neck Surg VL - 133 IS - 8 N2 - OBJECTIVE: To review surgical interventions for pediatric unilateral vocal fold immobility (UVFI). DESIGN: Retrospective medical chart review. SETTING: Two tertiary academic centers. PATIENTS: All children who underwent vocal fold medialization for dysphonia, with or without aspiration, from January 2004 to September 2006. INTERVENTIONS: Injection laryngoplasty, ansa cervicalis-recurrent laryngeal nerve anastomosis, or thyroplasty. MAIN OUTCOME MEASURES: Age, sex, intervention, etiology, time from onset of UVFI to surgery, subjective success in improving voice, subjective duration of improvement, and complications. RESULTS: Twenty-seven procedures were performed in 15 patients (mean age, 10.6 years). Nineteen injection laryngoplasties, 3 thyroplasties (1 bilateral), 2 ansa cervicalis-recurrent laryngeal nerve reinnervation procedures, 1 adduction arytenoidopexy, and 1 cricothyroid joint subluxation were performed. Causes of UVFI included thoracic surgery in 6 cases (40%), prolonged intubation in 4 (26%), central nervous system neoplasm in 3 (20%), unknown etiology in 1 (7%), and anoxic brain injury in 1 (7%). The mean duration from onset of symptoms to treatment was 47 months. There was 1 surgical complication (postoperative aspiration pneumonia following thyroplasty while the patient was under local anesthesia). Parents reported a satisfactory outcome in all cases. CONCLUSIONS: Injection laryngoplasty, thyroplasty, and nerve reinnervation can be performed in pediatric patients with good outcomes and an acceptable safety profile. This article describes the experiences of 2 institutions with phonosurgery for UVFI in children and provides insight into the advantages and disadvantages of each procedure. Prospective studies, with validated quality-of-life measurements, are needed to greater clarify the role of different types of phonosurgery in children with UVFI. SN - 0886-4470 UR - https://www.unboundmedicine.com/medline/citation/17709613/Vocal_fold_medialization_in_children:_injection_laryngoplasty_thyroplasty_or_nerve_reinnervation L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/archotol.133.8.767 DB - PRIME DP - Unbound Medicine ER -