Management of bilateral vocal fold paralysis in children.

IF 2 4区医学 Q2 OTORHINOLARYNGOLOGY

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-20 DOI:10.1097/MOO.0000000000001083

Olivia K G Hartley, Benjamin E J Hartley

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引用次数: 0

Abstract

Purpose of review: Bilateral vocal fold paralysis (BVFP) is a complex condition with a range of aetiologies and clinical presentations. Whilst spontaneous improvement may occur in a significant number of cases (48-70%), in the absence of recovery, multiple operations have been used to improve the airway. This review aims to analyse recent literature surrounding the management of BVFP and discuss changes in practice.

Recent findings: Suture lateralization in neonates is an emerging trend and has been recently reported to have good success rates in managing BVFP and preventing tracheostomy. Laryngeal electromyography (L-EMG) may be used to confirm the diagnosis and differentiate from fixation. Corticobulbar motor-evoked potentials (Co-MEPs) is a complimentary technique to L-EMG, which studies the corticobulbar tract and enables visualization of the motor pathway from the brainstem to the peripheral nerves. Currently, there is no reliable method available to predict prognosis. Recent comprehensive reviews of the published literature have described the outcomes for surgical intervention, with no technique proving clearly superior overall.

Summary: The wide range of aetiologies and the variable recovery rates mean standardized management of BVFP is not possible. L-EMG is not a reliable prognostic indicator of recovery. There is an emerging trend of suture lateralization to avoid tracheostomy. Extensive recent reviews have not identified a lateralization procedure that is superior overall. Small numbers of bilateral reinnervation have reported worldwide (n = 26) with some vocal cord recovery reported but relatively low decannulation rates at present (66%).

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儿童双侧声带麻痹的处理。

综述目的：双侧声带麻痹（BVFP）是一种复杂的疾病，具有多种病因和临床表现。虽然在相当数量的病例中（48-70%）可能会自发改善，但在没有恢复的情况下，多次手术已被用于改善气道。这篇综述旨在分析最近关于BVFP管理的文献，并讨论实践中的变化。最近的研究结果：新生儿缝线侧向化是一种新兴趋势，最近有报道称缝线侧向化在治疗BVFP和预防气管切开术方面具有良好的成功率。喉肌电图（L-EMG）可用于确认诊断和区分固定。皮质球运动诱发电位（Co-MEPs）是一种与左旋肌电图互补的技术，它研究皮质球束并使从脑干到周围神经的运动通路可视化。目前，尚无可靠的方法预测预后。最近对已发表文献的综合综述描述了手术干预的结果，没有一种技术证明明显优于整体。摘要：BVFP的病因范围广，恢复率多变，这意味着不可能进行标准化管理。左肌电图不是一个可靠的康复预后指标。为了避免气管切开术，缝合侧化已成为一种新趋势。最近广泛的综述并没有发现一种总体上更优越的侧化手术。世界范围内报道了少数双侧神经再生（n = 26），报道了一些声带恢复，但目前的脱管率相对较低（66%）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Otolaryngology & Head and Neck Surgery OTORHINOLARYNGOLOGY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.