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Injection laryngoplasty in infants with unilateral vocal cord paralysis: A survey of ASPO members. Int J Pediatr Otorhinolaryngol 2020 Jan;128:109671

Date

11/23/2019

Pubmed ID

31756694

DOI

10.1016/j.ijporl.2019.109671

Scopus ID

2-s2.0-85075054454   2 Citations

Abstract

INTRODUCTION: Unilateral vocal cord paralysis (UVCP) in infants may be managed medically or surgically, with the latter including injection laryngoplasty (IL). However, there is limited information regarding injection laryngoplasty in infants. We therefore proposed a survey of American Society of Pediatric Otolaryngology (ASPO) members to elucidate current practices, outcomes, and complications.

METHODS: An online survey was distributed to all 548 ASPO members via email. The survey was closed for data analysis 2 months after initial distribution. Statistical analysis was deferred due to the primarily descriptive nature of the data and lack of comparative studies.

RESULTS: We received 113 responses for a response rate of 20.6%. Only 31% of the respondents (n = 36) reported performing IL in infants 12 months old or younger. The most commonly cited reasons for not injecting in this age group were preference for non-surgical management and concern for increased risk of airway obstruction. IL was most commonly performed to treat persistent aspiration despite attempts at medical management. The majority (66%) reported no complications, while the remainder noted stridor requiring intensive care unit observation. Re-intubation due to airway obstruction occurred in 6% (n = 2 of 33). Carboxymethylcellulose gel (Prolaryn Gel) was the most commonly used injectable material, but a variety of other materials were used as well. Two respondents noted they perform reinnervation procedures in children, but not in infants, as they require at least a 12 month period of observation for possible spontaneous recovery before considering the option.

DISCUSSION: There is limited data regarding management of UVCP in infants with IL, and considerable variation among those who do perform the procedure. While adverse events are rare, multi-institutional studies should be considered to help determine best practices.

Author List

Jang M, Gregory S, Jabbour J, Robey TC, Sulman C, Chun R

Authors

Robert H. Chun MD Professor in the Otolaryngology department at Medical College of Wisconsin
Thomas C. Robey MD Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Female
Health Care Surveys
Humans
Infant
Infant, Newborn
Injections
Laryngoplasty
Male
Otolaryngology
Pediatrics
Postoperative Complications
Practice Patterns, Physicians'
Societies, Medical
Treatment Outcome
Vocal Cord Paralysis