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Arytenoidectomy in children

C M Bower1, S S Choi, R T Cotton

  • 1Department of Otolaryngology and Maxillofacial Surgery, Children's Hospital Medical Center, Cincinnati, Ohio.

The Annals of Otology, Rhinology, and Laryngology
|April 1, 1994
PubMed
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Arytenoidectomy can help decannulate children with bilateral vocal cord paralysis when spontaneous recovery fails. External laryngofissure arytenoidectomy showed higher decannulation success rates than laser arytenoidectomy.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Airway Surgery
  • Pediatric Vocal Cord Disorders

Background:

  • Vocal cord paralysis is a significant cause of infant stridor, with high rates of non-spontaneous recovery.
  • Bilateral vocal cord paralysis frequently necessitates tracheotomy for airway management.
  • Arytenoidectomy offers a surgical option for decannulation when conservative measures fail.

Purpose of the Study:

  • To evaluate the efficacy of arytenoidectomy in decannulating children with bilateral vocal cord paralysis.
  • To compare outcomes of different arytenoidectomy techniques in this pediatric population.
  • To identify factors influencing decannulation success after arytenoidectomy.

Main Methods:

  • Retrospective review of 30 pediatric patients with bilateral vocal cord paralysis undergoing arytenoidectomy.

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  • Surgical procedures included external laryngofissure, laser arytenoidectomy, and Woodman procedure.
  • Data analysis focused on decannulation rates, technique comparison, and complication assessment.

    • Main Results:

    • 83% of patients (25/30) were successfully decannulated after arytenoidectomy.
    • External laryngofissure arytenoidectomy achieved a higher decannulation rate (84%) compared to laser arytenoidectomy (56%).
    • Voice quality remained adequate postoperatively, with aspiration being a rare complication.

    Conclusions:

    • Arytenoidectomy, particularly via external laryngofissure, is an effective surgical intervention for decannulation in children with bilateral vocal cord paralysis.
    • Surgical technique and patient comorbidities influence decannulation outcomes.
    • Observation for spontaneous resolution is recommended prior to surgical intervention.