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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Laryngeal problems following infant esophageal surgery
The Laryngoscope
|July 1, 1976
Summary
Vocal cord paralysis can occur in children after surgery for tracheoesophageal fistula or esophageal atresia. The Thornell arytenoidectomy showed success in treating these cases, even without a tracheotomy.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Pediatric Neurology
Background:
- Congenital esophageal atresia and tracheoesophageal fistula are complex conditions requiring surgical intervention.
- Postoperative vocal cord paralysis is a known complication in pediatric patients undergoing these procedures.
- Laryngeal symptoms can significantly impact a child's quality of life and respiratory function.
Purpose of the Study:
- To investigate the incidence and management of vocal cord paralysis in children following surgery for tracheoesophageal fistula and/or esophageal atresia.
- To evaluate the effectiveness of different treatment modalities, including the Thornell arytenoidectomy.
Main Methods:
- Retrospective chart review of 65 children operated for congenital esophageal atresia and/or tracheoesophageal fistula (1964-1974).
- Analysis of patients presenting with laryngeal symptoms, specifically vocal cord paralysis.
- Assessment of treatment outcomes for various interventions, including Thornell arytenoidectomy.
Main Results:
- Ten of 65 children exhibited laryngeal symptoms; five were diagnosed with vocal cord paralysis.
- Two cases of vocal cord paralysis were successfully treated with the Thornell arytenoidectomy.
- One case of bilateral vocal cord paralysis due to hydrocephalus also responded well to the Thornell procedure.
- Follow-up laryngoscopy identified two unsuspected vocal cord paralyses and one paresis, which resolved.
Conclusions:
- Vocal cord paralysis is a significant complication after esophageal atresia and tracheoesophageal fistula repair in children.
- The Thornell arytenoidectomy appears to be an effective surgical option for managing vocal cord paralysis in this pediatric population.
- Early detection and appropriate intervention are crucial for improving outcomes in affected children.
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