Journal article
Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis
Otolaryngology-head and neck surgery, Vol.164(2), pp.255-263
02/2021
DOI: 10.1177/0194599820944892
PMCID: PMC10042623
PMID: 32689890
Abstract
Objectives
To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS.
Data Sources
PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta‐analyses) on September 9, 2019, with no date restriction.
Review Methods
Articles focusing on GWS or tracheostomy for initial management of BVFP were included. Articles describing patients who received no surgical intervention for BVFP were excluded.
Results
A total of 5989 articles were reviewed: 67 articles met inclusion criteria, and 240 patients were incorporated into the analysis. Patients who underwent primary GWS had an eventual tracheostomy rate of 6.0% (5/83). There were no statistically significant differences in the rate of tracheostomy, reoperation, or mortality among cricoid split, suture lateralization, and cordectomy/cordotomy. Patients who underwent primary tracheostomy failed to achieve decannulation in 36.9% (58/157) of cases. Decannulation was more likely in tracheostomized children who received GWS than those who did not (odds ratio, 6.336; P <. 0001).
Conclusions
Most children who undergo primary GWS for BVFP avoid tracheostomy or reoperation. These data demonstrated no differences in surgical outcomes among the most common types of GWS for BVFP. For children who receive a tracheostomy as their first intervention for BVFP, GWS is associated with a significantly improved rate of decannulation.
Details
- Title: Subtitle
- Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis
- Creators
- Ryan Kendall Thorpe - University of IowaSohit Paul Kanotra - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Otolaryngology-head and neck surgery, Vol.164(2), pp.255-263
- DOI
- 10.1177/0194599820944892
- PMID
- 32689890
- PMCID
- PMC10042623
- NLM abbreviation
- Otolaryngol Head Neck Surg
- ISSN
- 0194-5998
- eISSN
- 1097-6817
- Publisher
- SAGE Publications
- Number of pages
- 9
- Grant note
- National Institutes of Health (UL1TR002537) Clinical and Translational Science Award, University of Iowa National Institute on Deafness and Other Communication Disorders National Institutes of Health (5T32DC000040)
- Language
- English
- Date published
- 02/2021
- Academic Unit
- Stead Family Department of Pediatrics; Otolaryngology
- Record Identifier
- 9984311438902771
Metrics
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