Case series: Suture lateralization for neonatal vocal fold movement disorders

Area of Science:

• Pediatric Otolaryngology
• Neonatal Airway Management
• Surgical Innovation

Background:

• Neonatal stridor can stem from bilateral vocal fold paralysis (BVFP) or paradoxical vocal fold movement (PVFM).
• Airway obstruction in infants necessitates timely intervention.
• Suture lateralization offers a minimally invasive, reversible surgical option compared to tracheostomy.

Purpose of the Study:

• To evaluate the efficacy of suture lateralization in infants with stridor caused by BVFP or PVFM.
• To assess suture lateralization as an alternative to tracheostomy in this population.

Main Methods:

• A retrospective review of six infants with stridor undergoing suture lateralization was performed.
• Infants had either BVFP or PVFM, with some cases linked to TUBB3 mutations.
• Procedures included combined endoscopic and open techniques.

Main Results:

• Suture lateralization successfully managed airway obstruction in 83% of infants, avoiding tracheostomy.
• All patients were extubated within 3 days post-procedure.
• Postoperative aspiration requiring feeding tube placement occurred in 83% of patients, with 80% tolerating purees at follow-up.

Conclusions:

• Suture lateralization is a viable alternative to tracheostomy for managing infant airway obstruction due to BVFP or PVFM.
• The procedure effectively maintains adequate airways post-intervention.
• A significant rate of postoperative aspiration necessitates careful feeding assessment and ongoing management.