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Vocal fold paralysis in infants with tracheoesophageal fistula

Yael Oestreicher-Kedem1, Ari DeRowe, Hagit Nagar

  • 1Pediatric Otolaryngology Unit, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. dkyo@013.net

The Annals of Otology, Rhinology, and Laryngology
|January 15, 2009
PubMed

Insights

Vocal fold paralysis is challenging to diagnose in infants with tracheoesophageal fistula (TEF). Early otolaryngologist examination before and after surgery is recommended to prevent recurrent laryngeal nerve injury.

Area of Science:

  • Pediatric Otolaryngology
  • Neonatal Care
  • Airway Management

Background:

  • Infants with tracheoesophageal fistula (TEF) present unique challenges in airway management.
  • Vocal fold paralysis can be a significant complication in this population.

Purpose of the Study:

  • To characterize the clinical presentation and management of vocal fold paralysis in infants with TEF.
  • To highlight the diagnostic difficulties and potential for recurrent laryngeal nerve injury.

Main Methods:

  • Retrospective case series of infants born with TEF.
  • Inclusion criteria: presentation with dyspnea or aphonia, diagnosis of vocal fold paralysis.
  • Diagnostic procedures included flexible laryngotracheobronchoscopy.

Main Results:

  • Six infants (5 male, 1 female) were studied.
  • Vocal fold paralysis was diagnosed between 14 days and 14 months of age.
  • Five infants required tracheostomy; stridor was present before and after TEF repair in one infant.

Conclusions:

  • Vocal fold paralysis in infants with TEF is difficult to diagnose.
  • Emphasize the risk of recurrent laryngeal nerve injury associated with TEF and its repair.
  • Recommend pre- and post-operative otolaryngologist evaluations for infants with TEF to assess vocal fold mobility and airway anomalies.
Abstract

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