Refine Search

New Search

Results: 34

(searched for: doi:10.1001/jamaoto.2013.803)
Save to Scifeed
Page of 1
Articles per Page
by
Show export options
  Select all
Chelsea Ridgway, Sarah Bouhabel, Lisa Martignetti, Yo Kishimoto, Nicole Y. K. Li-Jessen
JAMA Otolaryngology–Head & Neck Surgery; https://doi.org/10.1001/jamaoto.2021.1050

Abstract:
Importance Vocal fold paralysis (VFP) results from the disruption of neural motor outputs to laryngeal muscles. Children with VFP manifest various degrees of difficulties in phonation, breathing, and swallowing. Although the etiologic characteristics and symptoms of VFP are well established in adults, corresponding clinical profiles are notably different in children. Clinical management of VFP is particularly challenging in children because their larynges are still actively developing and the recovery of disrupted laryngeal nerves is often unpredictable. This review discusses the neurologic conditions and diagnostic and treatment considerations in pediatric VFP. Observations Injury to the peripheral laryngeal nerves and certain central nervous system diseases, such as Arnold-Chiari malformation type II, can result in VFP in infants and children. The incidence of unilateral vs bilateral VFP is variable across pediatric studies. Most reported VFP cases are associated with injury of the recurrent laryngeal nerve. Laryngeal electromyography requires needle insertion that must be performed under anesthesia with special care in the pediatric setting. Neither normative values nor standardized procedures of laryngeal electromyography are currently established for the pediatric population. Laryngeal reinnervation, endoscopic arytenoid abduction lateropexy, and laryngeal pacing are plausible treatment options for pediatric VFP. Despite these new advances in the field, no corresponding efficacy data are available for clinicians to discern which type of patients would be the best candidates for these procedures. Conclusions and Relevance The neuroanatomy and neurophysiology of VFP remain more elusive for the pediatric population than for adults. Basic and clinical research is warranted to fully comprehend the complexity of this laryngeal movement disorder and to better inform and standardize clinical practice.
Aditi Sinha, Alexander Geragotellis, Guntaj Kaur Singh, Devika Verma, Daniyal Matin Ansari, Abdullah Tarmahomed, Emma Whitehall, Natalie Lowe, Amer Ashry,
Cardiology in the Young pp 1-9; https://doi.org/10.1017/s1047951121001165

Abstract:
Background: Vocal cord palsy is one of the recognised complications of complex cardiac surgery in the paediatric population. While there is an abundance of literature highlighting the presence of this complication, there is a scarcity of research focusing on the pathophysiology, presentation, diagnosis, and treatment options available for children affected by vocal cord palsy. Materials and methods: Electronic searches were conducted using the search terms: “Vocal Cord Palsy,” “VCP,” “Vocal Cord Injury,” “Paediatric Heart Surgery,” “Congenital Heart Surgery,” “Pediatric Heart Surgery,” “Vocal Fold Movement Impairment,” “VFMI,” “Vocal Fold Palsy,” “PDA Ligation.” The inclusion criteria were any articles discussing the outcomes of vocal cord palsy following paediatric cardiac surgery. Results: The two main populations affected by vocal cord palsy are children undergoing aortic arch surgery or those undergoing PDA ligation. There is paucity of prospective follow-up studies; it is therefore difficult to reliably assess the current approaches and the long-term implications of management options. Conclusion: Vocal cord palsy can be a devastating complication following cardiac surgery, which if left untreated, could potentially result in debilitation of quality of life and in severe circumstances could even lead to death. Currently, there is not enough high-quality evidence in the literature to aid recognition, diagnosis, and management leaving clinicians to extrapolate evidence from adult studies to make clinical judgements. Future research with a focus on the paediatric perspective is necessary in providing evidence for good standards of care.
, Camila Barbosa Marinho, Silvio José De Vasconcelos
International Journal of Pediatric Otorhinolaryngology, Volume 141; https://doi.org/10.1016/j.ijporl.2020.110553

The publisher has not yet granted permission to display this abstract.
, Alix Maltezeanu, Hélène Broucqsault, Sam J. Daniel
International Journal of Pediatric Otorhinolaryngology, Volume 138; https://doi.org/10.1016/j.ijporl.2020.110254

The publisher has not yet granted permission to display this abstract.
Janet W. Lee, Nicolas Bon-Mardion, Marshall E. Smith, Jean-Paul Marie
JAMA Otolaryngology–Head & Neck Surgery, Volume 146; https://doi.org/10.1001/jamaoto.2019.4863

Abstract:
ImportanceBilateral vocal fold paralysis (BVFP) in pediatric patients is a challenging entity with multiple causes. Traditional approaches to managing BVFP include tracheostomy, arytenoidectomy, suture lateralization, cordotomy, and posterior cricoid enlargement. These interventions are used to create a stable airway but risk compromising voice quality.ObjectivesTo assess the use of bilateral selective laryngeal reinnervation (SLR) surgery to manage BVFP and restore dynamic function to the larynx in pediatric patients.Design, Setting, and ParticipantsIn this case series performed at 2 tertiary care academic institutions, 8 pediatric patients underwent bilateral SLR to treat BVFP (5 patients with iatrogenic BVFP and 3 with congenital BVFP) from November 2004 to August 2018 with follow-up for at least 1.5 years.InterventionsBilateral selective laryngeal reinnervation surgery.Main Outcomes and MeasuresFlexible laryngoscopy findings, subjective and objective measures of voice quality, subjective swallowing function, and decannulation in patients who were previously dependent on a tracheostomy tube.ResultsParticipants included 6 boys and 2 girls with a median age of 9.3 (range, 2.2 to 18.0) years at the time of surgery. All 8 patients were decannulated; 6 patients had preoperative tracheostomies and 2 had perioperative tracheostomies. Voice quality, as measured using the GRBAS (grade, roughness, breathiness, asthenia, strain) scale, improved in 6 of 8 patients after reinnervation, and swallowing was not impaired in any patients. In 2 patients, GRBAS scale scores remained the same before and after surgery. Inspiratory vocal fold abduction was observed on both sides in 5 patients and on 1 side in 2 patients, with no active abduction observed in 1 patient. The follow-up period was more than 5 years in 7 of 8 patients and at least 1.5 years in all patients.Conclusions and RelevanceBilateral SLR appears to be a promising treatment option for children with BVFP; it is currently the only option, to our knowledge, with the potential to restore abductor and adductor vocal fold movement. In patients with complete paralysis, this procedure may provide a strategy for airway management and restoration of the dynamic function of the larynx. It could be considered as a first-line technique before endolaryngeal or airway framework procedures, which carry a risk of compromising voice quality.
Published: 6 April 2020
Auris Nasus Larynx, Volume 47, pp 315-334; https://doi.org/10.1016/j.anl.2020.03.001

The publisher has not yet granted permission to display this abstract.
Kenneth R. Feehs, Richard W. Thomas,
Neurologic and Neurodegenerative Diseases of the Larynx pp 355-364; https://doi.org/10.1007/978-3-030-28852-5_30

The publisher has not yet granted permission to display this abstract.
Published: 10 January 2020
Progress in Pediatric Surgery pp 649-658; https://doi.org/10.1007/978-3-662-43588-5_47

The publisher has not yet granted permission to display this abstract.
, Marshall E. Smith
Annals of Otology, Rhinology & Laryngology, Volume 129, pp 355-360; https://doi.org/10.1177/0003489419888956

Abstract:
Objectives: Recurrent laryngeal nerve (RLN) injury may be a consequence of surgical procedures of the skull base, neck, and chest, with adverse consequences to function and quality of life. Laryngeal reinnervation offers a potentially stable improvement in vocal fold position and tone. The classic donor nerve is the ansa cervicalis, but is not always available due to damage or sacrifice during previous neck surgeries. Our objective was to introduce the nerve to the thyrohyoid (TH) muscle as an alternate donor nerve for reinnervation, which has not previously been described. Methods: Case series of two patients using the TH nerve for laryngeal reinnervation after RLN injury, with description of surgical harvest. Results: Follow-up results are available for 10 months (one patient) and 3 years (one patient) demonstrating both subjective and objective improvement in function. GRBAS scores were reduced. Maximal phonation time was improved. Patient rating of voice was stable or improved postoperatively. One patient described significant preoperative dyspnea which was significantly improved postoperatively, from a score of 24 to 10 out of 40 on the dyspnea handicap index. VHI was improved in one patient, but scores elevated in the other, despite a change from “moderately severe impairment” to “normal voice” subjectively. Neither patient experienced significant complications from the procedure. Conclusion: Laryngeal reinnervation procedures provide good outcomes in pediatric patients. When ansa cervicalis is not available as a donor nerve, the nerve to TH provides a reasonable alternative.
Christen L. Caloway, Sarah Bouhabel,
International Journal of Pediatric Otorhinolaryngology, Volume 128; https://doi.org/10.1016/j.ijporl.2019.109742

The publisher has not yet granted permission to display this abstract.
Daniel J. Cates,
Decision Making in Vocal Fold Paralysis pp 41-55; https://doi.org/10.1007/978-3-030-23475-1_4

The publisher has not yet granted permission to display this abstract.
, , Sarah Hollas, Danielle Devore, Teresa Procter, Ethan Bassett, Aloysia Schwabe
Laryngoscope Investigative Otolaryngology, Volume 130, pp 1525-1531; https://doi.org/10.1002/lary.28282

The publisher has not yet granted permission to display this abstract.
, Julina Ongkasuwan
Otolaryngologic Clinics of North America, Volume 52, pp 949-956; https://doi.org/10.1016/j.otc.2019.06.006

The publisher has not yet granted permission to display this abstract.
Lesley J. Cavalli, Lesley A. Cochrane
Current Opinion in Otolaryngology & Head and Neck Surgery, Volume 27, pp 178-184; https://doi.org/10.1097/moo.0000000000000533

Abstract:
The current article reviews advances in both the assessment of paediatric voice disorders, as well as surgical, medical and therapeutic treatments. It is important to evaluate the impact of a voice disorder from both the parent and child perspective. Outpatient laryngoscopy with stroboscopy is very possible even in young children; however, high-speed ultrasound is a plausible alternative. High-speed videolaryngoscopy, videokymography and dynamic computed tomography, offer potential for augmenting the assessment of vocal fold vibratory characteristics in children. The evidence to support the efficacy of both indirect and direct voice therapy interventions is growing. The management of vocal fold palsy has advanced to include laryngeal reinnervation. Intubation injury with/without surgical intervention offers challenge and gives rise to voice disorders that may be lifelong. Although assessment and management practices of paediatric voice disorders closely follow those applied to adults, there are important differences and a developmental approach is required when considering both surgical and therapeutic management. Children can benefit from both indirect and direct therapy treatments following an ear, nose and throat assessment which utilizes paediatric instrumentation and considers the health of the entire airway. Underlying medical contributory factors should be explored and treated. Voice disorders due to congenital and acquired changes of the vocal tract may be amenable to surgery.
Christen L. Caloway, Gillian R. Diercks, Gregory Randolph,
Laryngoscope Investigative Otolaryngology, Volume 130, pp 747-751; https://doi.org/10.1002/lary.28135

The publisher has not yet granted permission to display this abstract.
, Marshall E. Smith
Otolaryngologic Clinics of North America, Volume 52, pp 681-692; https://doi.org/10.1016/j.otc.2019.03.012

The publisher has not yet granted permission to display this abstract.
Maria Catalina Espinosa,
Current Opinion in Otolaryngology & Head and Neck Surgery, Volume 26, pp 431-436; https://doi.org/10.1097/moo.0000000000000499

Abstract:
Ansa to recurrent laryngeal nerve reinnervation, otherwise known as a nonselective laryngeal reinnervation (NSLR), is growing in popularity for the management of pediatric unilateral neuronal vocal fold movement impairment (VFMI). In this chapter, we will review the current treatment options for neuronal VFMI and role that NSLR plays in the treatment algorithm. In 2018, Bouhabel and Hartnick published a survey of fellowship trained pediatric otolaryngologists and found an increasing comfort level with NSLR. Respondents felt that NSLR resulted in favorable subjective and objective postsurgical voice outcomes. Furthermore, NSLR may decrease the risk of aspiration in children with neuronal VFMI. Although NSLR appears to work, the voice results are not perfect for all children. Further work is being done to understand which preoperative variables, such as age, time from injury, and preop laryngeal electromyography, may predict a better voice outcome. A variety of treatment options exist for unilateral neuronal VFMI. Recent data and developments demonstrate the effectiveness of reinnervation as a potential first-line surgical intervention in children with unilateral neuronal VFMI.
Stephen Z. Shapiro, Scott E. Brietzke, Sweeti V. Shah,
International Journal of Pediatric Otorhinolaryngology, Volume 117, pp 127-130; https://doi.org/10.1016/j.ijporl.2018.11.020

The publisher has not yet granted permission to display this abstract.
Nikolaus E. Wolter, Nohamin Ayele, Kosuke Kawai, Anne Hseu,
Annals of Otology, Rhinology & Laryngology, Volume 128, pp 145-151; https://doi.org/10.1177/0003489418814276

Abstract:
Objectives: The aims of this study were to describe the impact of laryngoplasty in pediatric unilateral vocal fold immobility (UVFI) and to determine the impact of etiology and technique on voice and swallowing. Methods: A retrospective review was conducted of all children with UVFI undergoing medialization laryngoplasty at a pediatric hospital (2010-2017). Data including demographics, etiology, subjective voice quality, and swallowing function were collected. Results: The median age at first surgery among 25 patients with UVFI was 11 years (range, 1.2-25 years). The causes of UVFI were iatrogenic (76%), congenital (16%), and idiopathic (8%). A total of 38 laryngoplasties (24 injections, 11 Silastic implants, 3 Gore-Tex) were performed. Postoperatively, 78% of patients reported improvements in voice and 81% in swallowing. The median duration of voice improvement was 1.0 years (range, 0.1-10 years), with no significant difference by etiology or laryngoplasty technique. Patients who were ⩾10 years of age at surgery reported voice improvement significantly more often than patients <10 years of age at surgery (94% vs 61%, P = .04). Conclusions: UVFI has a significant impact on health and quality of life. In this study we found that laryngoplasty is an effective way to address both voice and swallowing in pediatric UVFI. A greater proportion of children with improved voice quality were older at injection. Surprisingly, there was no difference in duration of voice improvement between permanent and absorbable materials. Although this duration would be considered acceptable for many injectable materials, the limited duration in permanent implantation techniques may represent the challenges of managing UVFI in the growing larynx of the pediatric population. Injection laryngoplasty with absorbable materials may serve as an adequate method of addressing UVFI in this population.
, Nikhila Raol
Published: 4 October 2018
Pediatric Dysphagia pp 191-206; https://doi.org/10.1007/978-3-319-97025-7_16

The publisher has not yet granted permission to display this abstract.
, Paul Carding,
Current Opinion in Otolaryngology & Head and Neck Surgery, Volume 26, pp 157-161; https://doi.org/10.1097/moo.0000000000000450

Abstract:
Unilateral vocal fold paralysis (UVFP) is a common cause of neurogenic dysphonia resulting in glottal insufficiency. To restore glottal sufficiency and reduce the presenting dysphonia, treatment involving either surgical intervention, voice therapy or a combination of the two is typically provided. Currently, there is no consensus for the most effective voice treatment for UVFP. This results in an inability to compare current studies, and a lack of treatment effectiveness for the management of UVFP. This study aims to review the most recent literature for the management of dysphonia due to UVFP to establish the current evidence base for voice treatment options. There was found to be a lack of consistency in the rationale, selection and timing of the surgical intervention and/or voice therapy being provided for patients with UVFP. Further consensus is required for the rationale and selection of voice treatment prescriptions for the management of UVFP in order to improve treatment effectiveness and voice outcomes in patients with UVFP.
, Kate Heathcote
Published: 11 August 2017
Neurolaryngology pp 185-200; https://doi.org/10.1007/978-3-319-61724-4_15

The publisher has not yet granted permission to display this abstract.
Carissa J. Wentland, Phillip C. Song,
Current Treatment Options in Pediatrics, Volume 2, pp 339-351; https://doi.org/10.1007/s40746-016-0067-3

The publisher has not yet granted permission to display this abstract.
Published: 1 January 2016
The publisher has not yet granted permission to display this abstract.
Annals of Otology, Rhinology & Laryngology, Volume 125, pp 433-438; https://doi.org/10.1177/0003489415615364

Abstract:
Objective: Outcomes of laryngeal reinnervation with ansa-cervicalis for unilateral vocal fold paralysis (UVFP) may be influenced by age of the patient and time interval between laryngeal nerve injury and reinnervation, suggesting less favorable outcomes in older patients and greater than 2-year time interval after injury. This study examines these issues in the pediatric population. Method: Review of prospectively collected data set of 35 children and adolescents (1-21 years) that underwent ansa-recurrent laryngeal nerve (RLN) laryngeal reinnervation for UVFP. Results: The time from RLN injury to reinnervation averaged 5.0 years (range, 0.8-15.2 years). No correlation was found between age at reinnervation ( r = 0.15) and patient- or parent-reported global percentage voice outcome or perceptual ratings. There was slight negative correlation in duration between RLN injury and reinnervation and voice outcomes ( r = −0.31). Postoperative voice self/surrogate global percentage rating average was 80.5% (range, 50%-100%), and perceptual rating GRBAS sum score average was 2.9 (range, 0-7). Conclusion: In pediatric ansa-RLN reinnervation for UVFP, no correlation between age at surgery and postoperative outcome was found. Denervation duration showed slight negative correlation, similar to what has been reported in adults, though voice improvement was seen in all patients.
, Nicole M. Reusser, , Apurva A. Thekdi, James T. Albright,
International Journal of Pediatric Otorhinolaryngology, Volume 79, pp 1320-1323; https://doi.org/10.1016/j.ijporl.2015.06.001

The publisher has not yet granted permission to display this abstract.
Page of 1
Articles per Page
by
Show export options
  Select all
Back to Top Top