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Endoscopic arytenoid abduction lateropexy for the treatment of neonatal bilateral vocal cord paralysis - Long-term results.
Int J Pediatr Otorhinolaryngol. 2019 Apr; 119:147-150.IJ

Abstract

OBJECTIVES

Bilateral vocal cord paralysis often causes severe dyspnea requiring an early airway intervention in neonates. Endoscopic arytenoid abduction lateropexy (EAAL) with suture is a quick, reversible, minimally-invasive vocal cord lateralizing technique to enlarge the glottis. The arytenoid cartilage is directly lateralized to a normal abducted position. It can be performed even in early childhood with the recently-introduced pediatric endoscopic thread guide instrument. The long-term results and the stability of the lateralization were evaluated.

METHODS

Three newborns had inspiratory stridor immediately after birth. Laryngo-tracheoscopy revealed bilateral vocal cord paralysis. Unilateral, left-sided endoscopic arytenoid abduction lateropexy was performed with supraglottic jet ventilation. The follow-up period was >3 years.

RESULTS

After extubation on the 4-7th postoperative day no dyspnea or swallowing disorder occurred. Laryngo-tracheoscopy, clinical growth charts and voice analysis showed satisfactory functional results.

CONCLUSIONS

The endoscopic arytenoid abduction lateropexy might be a favorable solution for neonatal bilateral vocal cord paralysis. In one step, airway patency can be achieved without irreversible damage to the glottic structures. Normal swallowing function was preserved. The results are durable, and neither medialization nor dyspnea re-appeared during observation.

Authors+Show Affiliations

Department of Otorhinolaryngology and Head and Neck Surgery Faculty of Medicine, University of Szeged, Szeged, Hungary. Electronic address: sztano.balazs@med.u-szeged.hu.Department of Otorhinolaryngology and Head and Neck Surgery Faculty of Medicine, University of Szeged, Szeged, Hungary.Department of Otorhinolaryngology and Head and Neck Surgery Faculty of Medicine, University of Szeged, Szeged, Hungary.Department of Otorhinolaryngology and Head and Neck Surgery Faculty of Medicine, University of Szeged, Szeged, Hungary.Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.Vanderbilt University Medical Center, Nashville, TN, USA.Department of Otorhinolaryngology and Head and Neck Surgery Faculty of Medicine, University of Szeged, Szeged, Hungary.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30708182

Citation

Sztanó, Balázs, et al. "Endoscopic Arytenoid Abduction Lateropexy for the Treatment of Neonatal Bilateral Vocal Cord Paralysis - Long-term Results." International Journal of Pediatric Otorhinolaryngology, vol. 119, 2019, pp. 147-150.
Sztanó B, Bach Á, Matievics V, et al. Endoscopic arytenoid abduction lateropexy for the treatment of neonatal bilateral vocal cord paralysis - Long-term results. Int J Pediatr Otorhinolaryngol. 2019;119:147-150.
Sztanó, B., Bach, Á., Matievics, V., Erdélyi, E., Szegesdi, I., Wootten, C. T., & Rovó, L. (2019). Endoscopic arytenoid abduction lateropexy for the treatment of neonatal bilateral vocal cord paralysis - Long-term results. International Journal of Pediatric Otorhinolaryngology, 119, 147-150. https://doi.org/10.1016/j.ijporl.2019.01.032
Sztanó B, et al. Endoscopic Arytenoid Abduction Lateropexy for the Treatment of Neonatal Bilateral Vocal Cord Paralysis - Long-term Results. Int J Pediatr Otorhinolaryngol. 2019;119:147-150. PubMed PMID: 30708182.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic arytenoid abduction lateropexy for the treatment of neonatal bilateral vocal cord paralysis - Long-term results. AU - Sztanó,Balázs, AU - Bach,Ádám, AU - Matievics,Vera, AU - Erdélyi,Eszter, AU - Szegesdi,Ilona, AU - Wootten,Christopher T, AU - Rovó,László, Y1 - 2019/01/22/ PY - 2018/11/26/received PY - 2019/01/08/revised PY - 2019/01/19/accepted PY - 2019/2/2/pubmed PY - 2019/4/13/medline PY - 2019/2/2/entrez KW - Bilateral vocal fold paralysis KW - Congenital dyspnea KW - Endolaryngeal thread guide instrument KW - Endoscopic arytenoid abduction lateropexy KW - Laterofixation KW - Vocal fold immobility SP - 147 EP - 150 JF - International journal of pediatric otorhinolaryngology JO - Int J Pediatr Otorhinolaryngol VL - 119 N2 - OBJECTIVES: Bilateral vocal cord paralysis often causes severe dyspnea requiring an early airway intervention in neonates. Endoscopic arytenoid abduction lateropexy (EAAL) with suture is a quick, reversible, minimally-invasive vocal cord lateralizing technique to enlarge the glottis. The arytenoid cartilage is directly lateralized to a normal abducted position. It can be performed even in early childhood with the recently-introduced pediatric endoscopic thread guide instrument. The long-term results and the stability of the lateralization were evaluated. METHODS: Three newborns had inspiratory stridor immediately after birth. Laryngo-tracheoscopy revealed bilateral vocal cord paralysis. Unilateral, left-sided endoscopic arytenoid abduction lateropexy was performed with supraglottic jet ventilation. The follow-up period was >3 years. RESULTS: After extubation on the 4-7th postoperative day no dyspnea or swallowing disorder occurred. Laryngo-tracheoscopy, clinical growth charts and voice analysis showed satisfactory functional results. CONCLUSIONS: The endoscopic arytenoid abduction lateropexy might be a favorable solution for neonatal bilateral vocal cord paralysis. In one step, airway patency can be achieved without irreversible damage to the glottic structures. Normal swallowing function was preserved. The results are durable, and neither medialization nor dyspnea re-appeared during observation. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/30708182/Endoscopic_arytenoid_abduction_lateropexy_for_the_treatment_of_neonatal_bilateral_vocal_cord_paralysis___Long_term_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(19)30043-6 DB - PRIME DP - Unbound Medicine ER -