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Interarytenoid sodium carboxymethylcellulose gel injection for management of pediatric aspiration

David L Horn1, Kim DeMarre2, Sanjay R Parikh3

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine; Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA david.horn@seattlechildrens.org.

The Annals of Otology, Rhinology, and Laryngology
|June 26, 2014
PubMed

Insights

Interarytenoid injection laryngoplasty (IL) improved chronic aspiration in 57% of pediatric patients. This procedure may help select patients with posterior laryngeal clefts for further treatment.

Area of Science:

  • Pediatric Otolaryngology
  • Speech and Swallowing Disorders

Background:

  • Chronic aspiration in children poses significant management challenges.
  • Interarytenoid injection laryngoplasty (IL) is a potential therapeutic option.

Purpose of the Study:

  • To evaluate the efficacy of interarytenoid injection laryngoplasty (IL) in managing pediatric chronic aspiration.
  • To explore the influence of posterior laryngeal cleft type 1 (PLC-1) on treatment outcomes.

Main Methods:

  • Retrospective review of 30 pediatric patients with radiographically confirmed chronic aspiration who underwent intraoperative IL.
  • Clinical improvement was defined as successful advancement of feeding consistencies.

Main Results:

  • Overall clinical improvement was observed in 57% of patients following IL.
  • Patients with PLC-1 did not show significantly higher improvement rates compared to those without PLC-1.
  • PLC-1 was associated with older age, increased neurodevelopmental risk factors, and a higher likelihood of symptom recurrence after IL.

Conclusions:

  • Interarytenoid injection laryngoplasty (IL) can lead to improvement in chronic aspiration, even in patients with normal laryngeal anatomy.
  • IL may aid in selecting pediatric patients with PLC-1 for subsequent endoscopic repair.
  • Further prospective research is warranted to investigate the role of interarytenoid incompetence in aspiration without PLC-1.
Abstract

Keywords:
Radiesseaspirationcarboxymethylcellulose sodiumdysphagiainterarytenoid injectionposterior laryngeal cleft

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