Swallowing function in pediatric patients with bilateral vocal fold immobility

Area of Science:

• Pediatric Otolaryngology
• Swallowing Disorders
• Vocal Fold Physiology

Background:

• Infants with bilateral vocal fold immobility (BVFI) present with compromised airway and impaired swallowing.
• Long-term swallowing function in pediatric BVFI patients remains under-investigated.

Purpose of the Study:

• To characterize the longitudinal swallowing function in pediatric patients diagnosed with BVFI.
• To identify factors influencing long-term swallowing outcomes in this cohort.

Main Methods:

• Retrospective review of medical records for infants diagnosed with BVFI (2005-2014).
• Data collected included demographics, etiology, comorbidities, and swallow outcomes (gastrostomy tube dependence).
• Statistical analysis (Fisher's exact test) compared outcomes based on etiology, vocal fold status, and developmental delay.

Main Results:

• Twenty-three pediatric patients with BVFI had complete records; 56.5% required a gastrostomy tube at diagnosis.
• Only 30% of those with gastrostomy tubes eventually transitioned to oral feeding.
• Developmentally delayed children showed significantly poorer outcomes (33% gastrostomy-tube-free) compared to normally developed children (86%) (p=0.02).

Conclusions:

• Comorbidities are significant predictors of long-term swallowing function in pediatric BVFI.
• Return of vocal fold mobility does not correlate with improved swallow function.
• Developmental status is a critical factor in swallowing recovery for BVFI patients.