To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS.
Data Sources
PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) on September 9, 2019, with no date restriction.
Review Methods
Articles focusing on GWS or tracheostomy for initial management of BVFP were included. Articles describing patients who received no surgical intervention for BVFP were excluded.
Results
A total of 5989 articles were reviewed: 67 articles met inclusion criteria, and 240 patients were incorporated into the analysis. Patients who underwent primary GWS had an eventual tracheostomy rate of 6.0% (5/83). There were no statistically significant differences in the rate of tracheostomy, reoperation, or mortality among cricoid split, suture lateralization, and cordectomy/cordotomy. Patients who underwent primary tracheostomy failed to achieve decannulation in 36.9% (58/157) of cases. Decannulation was more likely in tracheostomized children who received GWS than those who did not (odds ratio, 6.336; P < .0001).
Conclusions
Most children who undergo primary GWS for BVFP avoid tracheostomy or reoperation. These data demonstrated no differences in surgical outcomes among the most common types of GWS for BVFP. For children who receive a tracheostomy as their first intervention for BVFP, GWS is associated with a significantly improved rate of decannulation.
LesnikMThierryBBlanchardM, et al. Idiopathic bilateral vocal cord paralysis in infants: case series and literature review. Laryngoscope. 2015;125(7):1724-1728. doi:10.1002/lary.25076
4.
GentileRDMillerRHWoodsonGE.Vocal cord paralysis in children 1 year of age and younger. Ann Otol Rhinol Laryngol. 1986;95(6):622-625. doi:10.1177/000348948609500616
RosinDFHandlerSDPotsicWPWetmoreRFTomLWC. Vocal cord paralysis in children. Laryngoscope. 1990;100(11):1174-1179. doi:10.1288/00005537-199011000-00008
7.
KremerBBotos-KremerAIEckelHESchlöndorffG.Indications, complications, and surgical techniques for pediatric tracheostomies—an update. J Pediatr Surg. 2002;37(11):1556-1562. doi:10.1053/jpsu.2002.36184
8.
ZbarRSmithR.Vocal fold paralysis in infants twelve months of age and younger. Otolaryngol Head Neck Surg. 1996;114(1):18-21. doi:10.1016/S0194-5998(96)70277-2
9.
LiYGarrettGZealearD.Current treatment options for bilateral vocal fold paralysis: a state-of-the-art review. Clin Exp Otorhinolaryngol. 2017;10(3):203-212. doi:10.21053/ceo.2017.00199
10.
GerberMEModiVKWardRFGowerVMThomsenJ.Endoscopic posterior cricoid split and costal cartilage graft placement in children. Otolaryngol Neck Surg. 2013;148(3):494-502. doi:10.1177/0194599812472435
11.
BriggerMTHartnickCJ.Surgery for pediatric vocal cord paralysis: a meta-analysis. Otolaryngol Neck Surg. 2002;126(4):349-355. doi:10.1067/mhn.2002.124185
12.
LiberatiA.The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):W65-W94. doi:10.7326/0003-4819-151-4-200908180-00136
13.
HowickJChalmersIGlasziouP, et al. The Oxford 2011 Levels of Evidence. Oxford Centre for Evidence-Based Medicine; 2011.
14.
MadaniSBachÁMatievicsV, et al. A new solution for neonatal bilateral vocal cord paralysis: endoscopic arytenoid abduction lateropexy. Laryngoscope. 2017;127(7):1608-1614. doi:10.1002/lary.26366
15.
FriedmanEMde JongALSulekM.Pediatric bilateral vocal fold immobility: the role of carbon dioxide laser posterior transverse partial cordectomy. Ann Otol Rhinol Laryngol. 2001;110(8):723-728. doi:10.1177/000348940111000805
16.
TrigliaJ-MBelusJ-FNicollasR.Arytenoidopexy for bilateral vocal fold paralysis in young children. J Laryngol Otol. 1996;110(11):1027-1030. doi:10.1017/S0022215100135674
17.
de GaudemarIRoudaireMFrançoisMNarcyP. Outcome of laryngeal paralysis in neonates: a long term retrospective study of 113 cases. Int J Pediatr Otorhinolaryngol. 1996;34(1-2):101-110. doi:10.1016/0165-5876(95)01262-1
18.
BrotelandeCLeboucqNAkkariM, et al. Isolated neonatal bilateral vocal cord paralysis revealing a unilateral medullary defect: a case report. BMC Pediatr. 2018;18(1):351. doi:10.1186/s12887-018-1329-y
19.
RufKHackenbergSKrausF, et al. Carbon dioxide laser cordotomy as possible alternative for tracheotomy in a neonate with idiopathic bilateral vocal fold paralysis. Klin Pädiatrie. 2016;228(4):213-215. doi:10.1055/s-0042-102253
20.
SimoninMD’AgostinoILebretonMJughonOHamzaJOualhaM.Bilateral vocal palsy following coin cell lithium battery ingestion: a case report and review. Eur J Pediatr. 2013;172(7):991-993. doi:10.1007/s00431-012-1899-x
21.
LacyPDHartleyBERutterMJCottonRT.Familial bilateral vocal cord paralysis and Charcot-Marie-Tooth disease type II-C. Arch Otolaryngol Neck Surg. 2001;127(3):322. doi:10.1001/archotol.127.3.322
22.
LewisAFCarronJDVedanarayananV.Congenital bilateral vocal fold paralysis and Charcot-Marie-Tooth disease. Ann Otol Rhinol Laryngol. 2010;119(1):47-49. doi:10.1177/000348941011900109
23.
LagierANicollasRSanjuanMBenoitLTrigliaJ-M.Laser cordotomy for the treatment of bilateral vocal cord paralysis in infants. Int J Pediatr Otorhinolaryngol. 2009;73(1):9-13. doi:10.1016/j.ijporl.2008.09.009
24.
KutscheraJFriedrichGUrlesbergerBEberEMuellerW.Endoscopic laser posterior cordectomy in a newborn with bilateral vocal fold paralysis and cerebro-oculo-facio-skeletal (Pena-Shokeir II) syndrome. Eur J Pediatr. 2004;163(2):120-121. doi:10.1007/s00431-003-1374-9
25.
ZambonAANatali SoraMGCantarellaG, et al. Vocal cord paralysis in Charcot-Marie-Tooth type 4b1 disease associated with a novel mutation in the myotubularin-related protein 2 gene: a case report and review of the literature. Neuromuscul Disord. 2017;27(5):487-491. doi:10.1016/j.nmd.2017.01.006
26.
DanielSJCardonaI.Cricothyroid onabotulinum toxin A injection to avert tracheostomy in bilateral vocal fold paralysis. JAMA Otolaryngol Neck Surg. 2014;140(9):867. doi:10.1001/jamaoto.2014.1515
27.
GraySDKellySMDoveH.Arytenoid separation for impaired pediatric vocal fold mobility. Ann Otol Rhinol Laryngol. 1994;103(7):510-515. doi:10.1177/000348949410300702
28.
LapeñaJFBerkowitzRG.Neuromuscular disorders presenting as congenital bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol. 2001;110(10):952-955. doi:10.1177/000348940111001011
29.
MalipatilSRPotnuruSKaradiRN.Vocal cord lateralization in bilateral abductor paralysis by extra-endo laryngeal suture technique: a case series. Indian J Otolaryngol Head Neck Surg. 2019;71(2):243-248. doi:10.1007/s12070-018-1408-2
30.
BowerCMChoiSSCottonRT.Arytenoidectomy in children. Ann Otol Rhinol Laryngol. 1994;103(4):271-278. doi:10.1177/000348949410300403
31.
CohenSR.Arytenoidectomy in children. Laryngoscope. 1973;83(8):1293-1299. doi:10.1288/00005537-197308000-00013
32.
KorenIKesselIRotschildACohen-KeremR.Bilateral vocal cord paralysis and hypothyroidism as presenting symptoms of Williams-Beuren syndrome: a case report. Int J Pediatr Otorhinolaryngol. 2015;79(9):1582-1583. doi:10.1016/j.ijporl.2015.06.023
33.
MathurN.KumarSBothraR.Simple method of vocal cord lateralization in bilateral abductor cord paralysis in paediatric patients. Int J Pediatr Otorhinolaryngol. 2004;68(1):15-20. doi:10.1016/j.ijporl.2003.08.050
34.
MuraliCLiDGrandKHakonarsonHBhojE.Isolated vocal cord paralysis in two siblings with compound heterozygous variants in MUSK: expanding the phenotypic spectrum. Am J Med Genet Part A. 2019;179(4):655-658. doi:10.1002/ajmg.a.61060
35.
OysuCTorosSZTepe-KaracaÇŞahinSSahin-YilmazA.Endoscopic posterior cordotomy with microdissection radiofrequency electrodes for bilateral vocal cord paralysis. Otolaryngol Neck Surg. 2014;150(1):103-106. doi:10.1177/0194599813513425
ClackZAAnandKJSFortenberryJDChamblissCR.Bilateral vocal cord paralysis after meningitis due toStreptococcus pneumoniae. South Med J. 1998;91(7):660-662. doi:10.1097/00007611-199807000-00010
40.
KoppelRFriedmanSFalletS.Congenital vocal cord paralysis with possible autosomal recessive inheritance: case report and review of the literature. Am J Med Genet. 1996;64(3):485-487. doi:10.1002/(SICI)1096-8628(19960823)64:3<485::AID-AJMG7>3.0.CO;2-O
41.
MurtyGEShinkwinCGibbinKP.Bilateral vocal fold paralysis in infants: tracheostomy or not?J Laryngol Otol. 1994;108(4):329-331. doi:10.1017/S0022215100126672
42.
MoriTGojiATodaY, et al. A 16q22.2-q23.1 deletion identified in a male infant with West syndrome. Brain Dev. 2019;41(10):888-893. doi:10.1016/j.braindev.2019.07.005
43.
SinghGBChauhanRKumarDAroraRRanjanS.Lithium battery ingestion: an unusual cause of bilateral cord palsy. Case Rep Otolaryngol. 2015;2015:1-3. doi:10.1155/2015/790830
44.
HsuAKRosowDEWallersteinRJ, April MM. Familial congenital bilateral vocal fold paralysis: a novel gene translocation. Int J Pediatr Otorhinolaryngol. 2015;79(3):323-327. doi:10.1016/j.ijporl.2014.12.009
45.
SedaghatSTapiaMFredesFRojasP.Endoscopic management of bilateral vocal fold paralysis in newborns and infants. Int J Pediatr Otorhinolaryngol. 2017;97:13-17. doi:10.1016/j.ijporl.2017.03.021
46.
KuoC-HNiuC-KYuH-RChungM-YHwangC-FHwangK-P.Applications of flexible bronchoscopy in infants with congenital vocal cord paralysis: a 12-year experience. Pediatr Neonatol. 2008;49(5):183-188. doi:10.1016/S1875-9572(09)60006-1
47.
KaushalMUpadhyayAAggarwalRDeorariAK.Congenital stridor due to bilateral vocal cord palsy. Indian J Pediatr. 2005;72(5):443-444. doi:10.1007/BF02731746
48.
AiutoLAPavlakisSGBoxerRA.Life-threatening organophosphate-induced delayed polyneuropathy in a child after accidental chlorpyrifos ingestion. J Pediatr. 1993;122(4):658-660. doi:10.1016/S0022-3476(05)83560-7
HawkinsDBLiu-ShindoMKahlstromEJMacLaughlinEF.Familial vocal cord dysfunction associated with digital anomalies. Laryngoscope. 1990;100(9):1001-1004. doi:10.1288/00005537-199009000-00015
51.
ThompsonJWRosenthalPCamilonFS.Vocal cord paralysis and superior laryngeal nerve dysfunction in Reye’s syndrome. Arch Otolaryngol Head Neck Surg. 1990;116(1):46-48. doi:10.1001/archotol.1990.01870010050015
52.
MyerCMFittonCM.Vocal cord paralysis following child abuse. Int J Pediatr Otorhinolaryngol. 1988;15(2):217-220. doi:10.1016/0165-5876(88)90074-2
PfenningerJ.Bilateral vocal cord paralysis after severe blunt head injury—a cause of failed extubation. Crit Care Med. 1987;15(7):701-702. doi:10.1097/00003246-198707000-00015
KanemotoNKanemotoKKamodaTHasegawaMArinamiT.A case of Moebius syndrome presenting with congenital bilateral vocal cord paralysis. Eur J Pediatr. 2007;166(8):831-833. doi:10.1007/s00431-006-0333-7
64.
HahnJSHenryMHudginsLMadanA.Congenital hypomyelination neuropathy in a newborn infant: unusual cause of diaphragmatic and vocal cord paralyses. Pediatrics. 2001;108(5):e95-e95. doi:10.1542/peds.108.5.e95
65.
BerkowitzRGMoxhamJPBankierAGardnerRJM. Chromosomal abnormalities in idiopathic congenital bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol. 2001;110(7):624-626. doi:10.1177/000348940111000706
66.
DavisLRossN.Bilateral vocal cord palsy after ventricular drainage in a child. Anesth Analg. 2001;92(2):358-361. doi:10.1097/00000539-200102000-00015
67.
ThakkarKGerberME.Endoscopic posterior costal cartilage graft placement for acute management of pediatric bilateral vocal fold paralysis without tracheostomy. Int J Pediatr Otorhinolaryngol. 2008;72(10):1555-1558. doi:10.1016/j.ijporl.2008.06.015
68.
ManaligodJMSmithRJH. Familial laryngeal paralysis. Am J Med Genet. 1998;77(4):277-280. doi:10.1002/(SICI)1096-8628(19980526)77:4<277::AID-AJMG5>3.0.CO;2-K
69.
StewartFJDalzellMMcReidMCinnamondMJ.Bilateral vocal cord paralysis in Williams syndrome. Clin Genet. 1993;44(3):164-165. doi:10.1111/j.1399-0004.1993.tb03870.x
HolingerPCHolingerLDVuckovichDMHolingerPH.Bilateral abductor vocal cord paralysis in Charcot-Marie-Tooth disease. Ann Otol Rhinol Laryngol. 1979;88(2):205-209. doi:10.1177/000348947908800210
73.
RandelRCKearnsDBNespecaMPScherCASawyerMH.Vocal cord paralysis as a presentation of intrauterine infection with varicella-zoster virus. Pediatrics. 1996;97(1):127-128.
74.
NunezDAHansonDR.Laryngeal reinnervation in children: the Leeds experience. Ear Nose Throat J. 1993;72(8):542-543.
75.
ShahJCiolekPHopkinsB.Novel endoscopic suturing technique to mitigate risk of graft extrusion in endoscopic posterior cricoid split and costal cartilage grafting: a case report. Int J Pediatr Otorhinolaryngol. 2018;109:164-167. doi:10.1016/j.ijporl.2018.04.012
76.
SztanóBBachÁMatievicsV, et al. Endoscopic arytenoid abduction lateropexy for the treatment of neonatal bilateral vocal cord paralysis – Long-term results. Int J Pediatr Otorhinolaryngol. 2019;119:147-150. doi:10.1016/j.ijporl.2019.01.032
77.
MontagueGLBlyRANadarajaGSConradDEParikhSRChanDK.Endoscopic percutaneous suture lateralization for neonatal bilateral vocal fold immobility. Int J Pediatr Otorhinolaryngol. 2018;108:120-124. doi:10.1016/j.ijporl.2018.02.032
78.
KingEFBluminJH.Vocal cord paralysis in children. Curr Opin Otolaryngol Head Neck Surg. 2009;17(6):483-487. doi:10.1097/MOO.0b013e328331b77e
79.
SahinMAydogduIAkyildizSErdincMOzturkKOgutF.Electromyography-guided botulinum toxin injection into the cricothyroid muscles in bilateral vocal fold abductor paralysis. Clin Exp Otorhinolaryngol. 2017;10(2):193-202. doi:10.21053/ceo.2016.00241
80.
FunamuraJLYuenSKawaiK, et al. Characterizing mortality in pediatric tracheostomy patients. Laryngoscope. 2017;127(7):1701-1706. doi:10.1002/lary.26361
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