Endoscopic arytenoid abduction lateropexy in pediatric vocal cord paralysis

Abstract

Objective: Vocal fold paralysis is an uncommon problem in children. Clinical presentation covers a wide range of signs and symptoms. Our objective is to evaluate de efficacy and security of the Endoscopic Arytenoid Abduction Lateropexy (EAAL) in pediatric patients with vocal cord paralysis and to present the results. Material and method: From January 2011 to September 2018 10 patients with vocal fold paralysis underwent examination and treatment. The mean age at treatment was 4.87 years old (2-16). The parameters considered at the pre-/postsurgical time for the clinical assessment of each patient were as follows: the presence or absence of stridor and respiratory distress, the existence or nonexistence of previous tracheostomy, voice alterations, and feeding aspiration events. The mean follow-up was 49.5 months (5-104). Results: EAAL were realized successfully in 10 patients. There were no complications associated with the surgical procedure. In terms of sequelae, we noted 2 cases of minimal liquid-feeding difficulties that were alleviated within three weeks of the surgery with the help of phoniatrics reeducation, and 5 cases of mild dysphonia. In 4 cases tracheostomy was avoided, in 4 cases patients with prior tracheostomy were successfully decannulated following EAAL. Conclusions: EAAL may be selected as a first-line technique in management of vocal cord paralysis, since it is minimally invasive, easy to perform, and produces satisfactory results.