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Injection Laryngoplasty for Children with Dysphagia after Cardiac Surgery

Derek Sheen1, Thomas K Houser1, Sofia E Olsson2

  • 1Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.

OTO Open
|May 1, 2024
PubMed

Insights

Injection laryngoplasty (IL) may help children with unilateral vocal cord paralysis (UVCP) after heart surgery, but its benefit over observation for resolving aspiration needs further study. More research is needed for this pediatric population.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Cardiology
  • Pediatric Gastroenterology

Background:

  • Unilateral vocal cord paralysis (UVCP) is a known complication following pediatric cardiac surgery.
  • Aspiration of thin liquids poses significant risks to affected children, including pneumonia and malnutrition.
  • Current management strategies for post-cardiac surgery UVCP-induced aspiration vary, necessitating evaluation of treatment efficacy.

Purpose of the Study:

  • To investigate the effectiveness of injection laryngoplasty (IL) in resolving thin liquid aspiration in children with UVCP post-cardiac surgery.
  • To compare aspiration resolution rates between children undergoing IL and those managed with observation.

Main Methods:

  • A retrospective case-control study was conducted at a tertiary children's hospital.
  • Included were children under 5 years old diagnosed with UVCP after cardiac surgery between 2012 and 2022.
  • Videofluoroscopic swallow studies (VFSS) were used to assess thin liquid aspiration resolution in the IL group (n=17) and the observation group (n=15).

Main Results:

  • While the IL group showed a higher resolution rate (82%) compared to the observation group (60%), this difference was not statistically significant (P=0.24).
  • However, the time to documented aspiration resolution was significantly longer in the IL group (47.4 months) than in the observation group (9.6 months) (P<0.001).
  • No surgical complications were reported following injection laryngoplasty.

Conclusions:

  • Injection laryngoplasty may offer a treatment option for aspiration in pediatric UVCP patients post-cardiac surgery.
  • The added benefit of IL over conservative observation for aspiration resolution remains uncertain.
  • Further research is warranted to clarify the role of IL in managing dysphagia in this specific pediatric population.
Abstract

Keywords:
aspirationcardiac surgeryinjection medialization laryngoplastypediatric dysphagiaunilateral vocal cord paralysis

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