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Laser arytenoidectomy in the management of bilateral vocal cord paralysis in children.
Int J Pediatr Otorhinolaryngol. 2010 May; 74(5):451-5.IJ

Abstract

OBJECTIVE

To analyse the efficacy of CO(2) laser arytenoidectomy in the management of bilateral vocal cord paralysis in children.

METHODS

Retrospective series of 17 patients who underwent laser arytenoidectomy for bilateral vocal cord between 1995 and 2008 in a tertiary care institution. All patients had bilateral laryngeal paralysis, in isolation (n=5) or associated with concomitant airway conditions (n=12). All cases had anterior prolapse of the arytenoids with partial obstruction of the airway on inspiration. 12/17 patients (70.5%) were tracheotomy-dependant, 2/17 were in-extubatable, and 3/17 had severe airway limitation, effort dyspnea and poor sleep pattern. Main outcome measures were decannulation rate for patients with tracheotomy, occurrence of aspiration and quality of voice.

RESULTS

The mean age was 2.8 years old. 9/12 patients with tracheotomy (75%) were decannulated with a median delay of 2 months (2 days to 18 months). Both of the intubated patients were extubated with a median delay of 36h. One of the decannulated patients who re-presented with a residual dyspnea after the arytenoidectomy was improved by a further laser cordotomy. 2/17 patients (11.7%) had post-operative persistent aspirations (with pneumopathies in one case), 5/17 patients were dysphonic, 3 improved with speech therapy and 2 with intracordal lipoinjection.

CONCLUSIONS

Laser arytenoidectomy is effective for improving the breathing in children presenting with a bilateral vocal fold paralysis associated with obstructive arytenoid prolapse. Results are good as a first-line surgery or following laryngo-tracheal surgery. Voice outcomes are satisfactory. However, aspiration is a rare complication.

Authors+Show Affiliations

ENT Department, Children's Hospital Trousseau, 26 avenue Docteur Arnold Netter, 75012 Paris, France. aubryorl@aol.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20163880

Citation

Aubry, Karine, et al. "Laser Arytenoidectomy in the Management of Bilateral Vocal Cord Paralysis in Children." International Journal of Pediatric Otorhinolaryngology, vol. 74, no. 5, 2010, pp. 451-5.
Aubry K, Leboulanger N, Harris R, et al. Laser arytenoidectomy in the management of bilateral vocal cord paralysis in children. Int J Pediatr Otorhinolaryngol. 2010;74(5):451-5.
Aubry, K., Leboulanger, N., Harris, R., Genty, E., Denoyelle, F., & Garabedian, E. N. (2010). Laser arytenoidectomy in the management of bilateral vocal cord paralysis in children. International Journal of Pediatric Otorhinolaryngology, 74(5), 451-5. https://doi.org/10.1016/j.ijporl.2010.01.019
Aubry K, et al. Laser Arytenoidectomy in the Management of Bilateral Vocal Cord Paralysis in Children. Int J Pediatr Otorhinolaryngol. 2010;74(5):451-5. PubMed PMID: 20163880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laser arytenoidectomy in the management of bilateral vocal cord paralysis in children. AU - Aubry,Karine, AU - Leboulanger,Nicolas, AU - Harris,Robert, AU - Genty,Erwan, AU - Denoyelle,Françoise, AU - Garabedian,Erea-Noël, Y1 - 2010/02/18/ PY - 2009/12/06/received PY - 2010/01/24/revised PY - 2010/01/26/accepted PY - 2010/2/19/entrez PY - 2010/2/19/pubmed PY - 2010/7/16/medline SP - 451 EP - 5 JF - International journal of pediatric otorhinolaryngology JO - Int J Pediatr Otorhinolaryngol VL - 74 IS - 5 N2 - OBJECTIVE: To analyse the efficacy of CO(2) laser arytenoidectomy in the management of bilateral vocal cord paralysis in children. METHODS: Retrospective series of 17 patients who underwent laser arytenoidectomy for bilateral vocal cord between 1995 and 2008 in a tertiary care institution. All patients had bilateral laryngeal paralysis, in isolation (n=5) or associated with concomitant airway conditions (n=12). All cases had anterior prolapse of the arytenoids with partial obstruction of the airway on inspiration. 12/17 patients (70.5%) were tracheotomy-dependant, 2/17 were in-extubatable, and 3/17 had severe airway limitation, effort dyspnea and poor sleep pattern. Main outcome measures were decannulation rate for patients with tracheotomy, occurrence of aspiration and quality of voice. RESULTS: The mean age was 2.8 years old. 9/12 patients with tracheotomy (75%) were decannulated with a median delay of 2 months (2 days to 18 months). Both of the intubated patients were extubated with a median delay of 36h. One of the decannulated patients who re-presented with a residual dyspnea after the arytenoidectomy was improved by a further laser cordotomy. 2/17 patients (11.7%) had post-operative persistent aspirations (with pneumopathies in one case), 5/17 patients were dysphonic, 3 improved with speech therapy and 2 with intracordal lipoinjection. CONCLUSIONS: Laser arytenoidectomy is effective for improving the breathing in children presenting with a bilateral vocal fold paralysis associated with obstructive arytenoid prolapse. Results are good as a first-line surgery or following laryngo-tracheal surgery. Voice outcomes are satisfactory. However, aspiration is a rare complication. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/20163880/Laser_arytenoidectomy_in_the_management_of_bilateral_vocal_cord_paralysis_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(10)00041-8 DB - PRIME DP - Unbound Medicine ER -