Prognosis of Dysphagia in Pediatric Patients With Vocal Fold Immobility.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-05-05 DOI:10.1002/ohn.1281

Rachel Georgopoulos, Khashayar Arianpour, Samantha Anne

{"title":"Prognosis of Dysphagia in Pediatric Patients With Vocal Fold Immobility.","authors":"Rachel Georgopoulos, Khashayar Arianpour, Samantha Anne","doi":"10.1002/ohn.1281","DOIUrl":null,"url":null,"abstract":"Objective: This study aims to determine the incidence and prognosis of dysphagia in pediatric patients with true vocal fold (TVF) immobility or hypomobility.Study design: A single-center retrospective chart review.Setting: A single-institution tertiary-care center.Methods: A total of 89 pediatric patients diagnosed with vocal fold hypo/immobility with a modified barium swallow (MBS) performed were examined. Patient demographic information and etiology of vocal fold immobility as well as laterality were reviewed. Changes in MBS findings over time were assessed.Results: A total of 89 pediatric patients were identified with a mean follow-up of 35.4 months. The most common etiology of TVF hypo/immobility was cardiothoracic surgery (58.4%).Immobility was observed in 80.6% of patients. Patients with unilateral disease were more likely to present with dysphonia than bilateral disease (40.3% vs 9.1%, odds ratio [OR] 6.75, 95% confidence interval [CI] 1.77-44.5, P = .01). MBS results did not vary statistically with respect to laterality, hypomobility versus immobility, or etiology. Of the 33 children who demonstrated aspiration on their initial MBS, 48.5% demonstrated complete resolution over median of 10.5 weeks. Rates of recovery differed only with respect to hypomobility versus immobility (87.5% vs 33.3%, OR 14.0, 95% CI 2.01-286, P = .0133).Conclusion: Based on the study results, about half of pediatric patients with vocal fold hypo/immobility will have resolution of dysphagia at about 10.5 weeks. This may helpful when deciding on when to obtain follow up imaging/exam on pediatric patients with dysphagia. The only factor that confers improved prognosis is hypomobility when compared to complete immobility.","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.1281","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This study aims to determine the incidence and prognosis of dysphagia in pediatric patients with true vocal fold (TVF) immobility or hypomobility.

Study design: A single-center retrospective chart review.

Setting: A single-institution tertiary-care center.

Methods: A total of 89 pediatric patients diagnosed with vocal fold hypo/immobility with a modified barium swallow (MBS) performed were examined. Patient demographic information and etiology of vocal fold immobility as well as laterality were reviewed. Changes in MBS findings over time were assessed.

Results: A total of 89 pediatric patients were identified with a mean follow-up of 35.4 months. The most common etiology of TVF hypo/immobility was cardiothoracic surgery (58.4%).Immobility was observed in 80.6% of patients. Patients with unilateral disease were more likely to present with dysphonia than bilateral disease (40.3% vs 9.1%, odds ratio [OR] 6.75, 95% confidence interval [CI] 1.77-44.5, P = .01). MBS results did not vary statistically with respect to laterality, hypomobility versus immobility, or etiology. Of the 33 children who demonstrated aspiration on their initial MBS, 48.5% demonstrated complete resolution over median of 10.5 weeks. Rates of recovery differed only with respect to hypomobility versus immobility (87.5% vs 33.3%, OR 14.0, 95% CI 2.01-286, P = .0133).

Conclusion: Based on the study results, about half of pediatric patients with vocal fold hypo/immobility will have resolution of dysphagia at about 10.5 weeks. This may helpful when deciding on when to obtain follow up imaging/exam on pediatric patients with dysphagia. The only factor that confers improved prognosis is hypomobility when compared to complete immobility.

查看原文本刊更多论文

小儿声带不动患者吞咽困难的预后。

目的：本研究旨在确定小儿真声带（TVF）不动或活动能力低下患者吞咽困难的发生率和预后。研究设计：单中心回顾性图表评价。环境：单一机构的三级护理中心。方法：对89例经改良钡餐（MBS）诊断为声带功能低下/不动的患儿进行检查。本文回顾了患者的人口学信息和声带不动及侧边的病因。评估MBS结果随时间的变化。结果：共确诊89例患儿，平均随访35.4个月。TVF低/不动最常见的病因是心胸外科手术（58.4%）。80.6%的患者出现活动不动。单侧疾病患者比双侧疾病患者更容易出现发声障碍（40.3% vs 9.1%，优势比[OR] 6.75, 95%可信区间[CI] 1.77-44.5, P = 0.01）。MBS的结果在侧边、活动能力低与不活动或病因方面没有统计学差异。在33名在初始MBS中表现出误吸的儿童中，48.5%的儿童在10.5周内表现出完全缓解。恢复率仅在不活动和不活动两组有差异（87.5% vs 33.3%, OR 14.0, 95% CI 2.01-286, P = 0.0133）。结论：根据研究结果，约有一半的小儿声带功能减退/不动患者在10.5周左右出现吞咽困难的缓解。这可能有助于决定何时对吞咽困难的儿童患者进行随访成像/检查。与完全不活动相比，唯一能改善预后的因素是活动能力不足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.