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Bilateral Vocal Fold Abduction Dysfunction: A Report of Two Neonatal Cases
Kenta Igami1,2, Yoshio Shima3, Sakae Kumasaka1
1Department of Pediatrics, Japanese Red Cross Tokyo Katsushika Perinatal Center.
Summary
Idiopathic vocal fold abduction dysfunction causes neonatal stridor. This condition, diagnosed via laryngo-bronchoscopy, often resolves with conservative treatment like biphasic positive airway pressure.
Area of Science:
- Pediatrics
- Otolaryngology
- Neonatology
Background:
- Stridor in newborns is commonly caused by laryngomalacia, but vocal fold abduction dysfunction is another significant cause.
- Idiopathic vocal fold abduction dysfunction presents a diagnostic challenge in neonates with inspiratory stridor.
Purpose of the Study:
- To present two cases of idiopathic vocal fold abduction dysfunction in neonates.
- To highlight the diagnostic and therapeutic approaches for this condition.
Main Methods:
- Case report of two neonates presenting with inspiratory stridor and cyanosis.
- Diagnostic confirmation using laryngo-bronchoscopy.
- Treatment with biphasic positive airway pressure.
Main Results:
- Both neonates diagnosed with idiopathic vocal fold abduction dysfunction showed improvement with biphasic positive airway pressure.
- Symptoms resolved within a few months, confirmed by repeat endoscopy.
- No dysmorphic features or cardiac abnormalities were noted in either case.
Conclusions:
- Idiopathic vocal fold abduction dysfunction is a crucial differential diagnosis for neonatal inspiratory stridor.
- Laryngo-bronchoscopy is essential for diagnosis, and many cases may be undiagnosed.
- Conservative management, including biphasic positive airway pressure, can be effective, though severe cases may require interventions like tracheostomy.
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