“…Success rate reported in the pediatric patients is 66–77% and markedly lower compared to adults [23, 24]. This fact is most probably due to the higher incidence of posterior glottic stenosis, subglottic stenosis, and other comorbid pathologies of the airway in the pediatric age group.…”
Introduction. Treatment for bilateral vocal fold paralysis (BVFP) has evolved from external irreversible procedures to endolaryngeal laser surgery with greater focus on anatomic and functional preservation. Since the introduction of endolaryngeal laser arytenoidectomy, certain modifications have been described, such as partial resection procedures and mucosa sparing techniques as opposed to total arytenoidectomy. Discussion. The primary outcome measure in studies on BVFP treatment using total or partial arytenoidectomy is avoidance of tracheotomy or decannulation and reported success ranges between 90 and 100% in this regard. Phonation is invariably affected and arytenoidectomy worsens both aerodynamic and acoustic vocal properties. Recent reports indicate that partial and total arytenoidectomies have similar outcome in respect to phonation and swallowing. We use CO2 laser assisted partial arytenoidectomy with a posteromedially based mucosal flap for primary cases and reserve total arytenoidectomy for revision. Lateral suturing of preserved mucosa provides tension on the vocal fold leading to better voice and leaves no raw surgical field to unpredictable scarring or granulation. Conclusion. Arytenoidectomy as a permanent static procedure remains a traditional yet sound choice in the treatment of BVFP. Laser dissection provides a precise dissection in a narrow surgical field and the possibility to perform partial arytenoidectomy.
“…Success rate reported in the pediatric patients is 66–77% and markedly lower compared to adults [23, 24]. This fact is most probably due to the higher incidence of posterior glottic stenosis, subglottic stenosis, and other comorbid pathologies of the airway in the pediatric age group.…”
Introduction. Treatment for bilateral vocal fold paralysis (BVFP) has evolved from external irreversible procedures to endolaryngeal laser surgery with greater focus on anatomic and functional preservation. Since the introduction of endolaryngeal laser arytenoidectomy, certain modifications have been described, such as partial resection procedures and mucosa sparing techniques as opposed to total arytenoidectomy. Discussion. The primary outcome measure in studies on BVFP treatment using total or partial arytenoidectomy is avoidance of tracheotomy or decannulation and reported success ranges between 90 and 100% in this regard. Phonation is invariably affected and arytenoidectomy worsens both aerodynamic and acoustic vocal properties. Recent reports indicate that partial and total arytenoidectomies have similar outcome in respect to phonation and swallowing. We use CO2 laser assisted partial arytenoidectomy with a posteromedially based mucosal flap for primary cases and reserve total arytenoidectomy for revision. Lateral suturing of preserved mucosa provides tension on the vocal fold leading to better voice and leaves no raw surgical field to unpredictable scarring or granulation. Conclusion. Arytenoidectomy as a permanent static procedure remains a traditional yet sound choice in the treatment of BVFP. Laser dissection provides a precise dissection in a narrow surgical field and the possibility to perform partial arytenoidectomy.
“…Sixteen articles had flaws that disqualified them from inclusion (sampling, diagnostic definition, incomplete follow up, and non-objective assessment of final outcome) [2,4,[6][7][8]14,[67][68][69][70][71][72][73][74][75][76]. Twenty-one articles were assessing glottic expansion procedures on highly selected groups [9,[77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96]. Three articles were studying a certain diagnostic modality [97][98][99].…”
Section: Electronic Search and Study Selectionmentioning
confidence: 99%
“…Adult population, not relevant 57 Hagan [53] Adult population 58 Ishman et al [52] Irrelevant, Studying the difference in the management of pediatric and adult population 59 Ahmad et al [64] Adult population 60 Clerf [54] Adult population, discussing surgical treatment 61 Dworkin and Treadway [55] Adult population 62 Fox [56] Adult population 63 Gorman and Woodward [57] Mixed adult and pediatric population without separate analysis 64 Hirose [66] Mixed adult and pediatric population without separate analysis 65 Kearsley [58] Adult population 66 King [59] Adult population, case reports 67 Pinto et al [60] Adult population 68 Renfrew [61] Adult population 69 Rinne [62] Adult population 70 Rosenthal et al [65] Adult population 71 Sellars [63] Adult population, studying the efficacy of surgical procedure 72 Chmielik et al [100] No enough information about the patients, no information about recovery 73 Cohen et al [101] No information about recovery 74 Daya et al [3] No information about recovery 75 Fearon and Ellis [102] No information about recovery 76 Holinger et al [103] No information about recovery 77 Holinger et al …”
Section: Proceedings Of the Royal Society Of Medicine 1934 [51]mentioning
“…Common surgical procedures include unilateral laser arytenoidectomy, cordotomy, or vocal fold lateralization. These procedures can all be conducted via an endoscopic approach and can create a patent airway without the need for tracheotomy [30][31][32]. Outcomes reported are based on retrospective or case reviews and concentrate on airway patency versus voice outcomes.…”
Section: Voice Care: Behavioral and Medical-surgicalmentioning
Pediatric voice and airway disorders are an important childhood health problem. Voice assessment in children should include formal perceptual and instrumental evaluations, including sophisticated acoustic, aerodynamic and imaging modalities. The care of these children requires a collaborative approach that includes systematic and innovative treatment methods.
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