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Endoscopic management of bilateral vocal fold paralysis in newborns and infants

Sahba Sedaghat1, Mario Tapia1, Felipe Fredes1

  • 1Otolaryngologyst at University of Concepcion and Hospital Guillermo Grant Benavente, Concepcion, Chile.

International Journal of Pediatric Otorhinolaryngology
|May 10, 2017
PubMed

Insights

Endoscopic anterior and posterior cricoid split (EAPCS) effectively resolves airway obstruction in infants with bilateral vocal cord paralysis in adducted position (BVCPAd), avoiding tracheostomy. This study highlights EAPCS as a promising alternative for pediatric airway management.

Area of Science:

  • Pediatric Otolaryngology
  • Airway Management
  • Surgical Innovation

Background:

  • Bilateral vocal cord paralysis in adducted position (BVCPAd) causes severe airway obstruction in infants, often requiring tracheostomy.
  • Tracheostomy in pediatric patients is associated with significant morbidity and mortality.
  • Conservative endoscopic procedures are emerging as alternatives to tracheostomy for BVCPAd.

Purpose of the Study:

  • To review the experience with endoscopic anterior and posterior cricoid split (EAPCS) in newborns and infants with BVCPAd.
  • To evaluate the efficacy of EAPCS in resolving airway obstruction and avoiding tracheostomy.

Main Methods:

  • Prospective study of pediatric patients undergoing endoscopic EAPCS for symptomatic BVCPAd.
  • Primary outcome measures included tracheostomy avoidance and resolution of airway symptoms.

Main Results:

  • Three infants underwent EAPCS between January 2016 and December 2016.
  • All patients experienced complete resolution of airway obstruction symptoms.
  • Tracheostomy was successfully avoided in all treated patients.

Conclusions:

  • Endoscopic anterior and posterior cricoid split (EAPCS) is a novel and effective treatment for BVCPAd in infants.
  • EAPCS offers a viable alternative to tracheostomy, potentially reducing associated complications.
  • Further research with more cases is needed to fully establish the benefits and patient selection criteria for EAPCS.
Abstract

Keywords:
AirwayBilateral vocal cord paralysisCricoid splitStridorVocal cord immobility

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