Screening for Vocal Fold Movement Impairment in Children Undergoing Esophageal and Airway Surgery.
EA
RLN
VFMI
esophageal atresia
prevalence
recurrent laryngeal nerve injury
screening
vocal fold movement impairment
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
04
02
2023
received:
02
12
2022
accepted:
27
02
2023
medline:
15
11
2023
pubmed:
10
3
2023
entrez:
9
3
2023
Statut:
ppublish
Résumé
Children undergoing cervical and/or thoracic operations are at risk for recurrent laryngeal nerve injury, resulting in vocal fold movement impairment (VFMI). Screening for VFMI is often reserved for symptomatic patients. Identify the prevalence of VFMI in screened preoperative patients prior to an at-risk operation to evaluate the value of screening all patients at-risk for VFMI, regardless of symptoms. A single center, retrospective review of all patients undergoing a preoperative flexible nasolaryngoscopy between 2017 and 2021, examining the presence of VFMI and associated symptoms. We evaluated 297 patients with a median (IQR) age of 18 (7.8, 56.3) months and a weight of 11.3 (7.8, 17.7) kilograms. Most had a history of esophageal atresia (EA, 60%), and a prior at-risk cervical or thoracic operation (73%). Overall, 72 (24%) patients presented with VFMI (51% left, 26% right, and 22% bilateral). Of patients with VFMI, 47% did not exhibit the classic symptoms (stridor, dysphonia, and aspiration) of VFMI. Dysphonia was the most prevalent classic VFMI symptom, yet only present in 18 (25%) patients. Patients presenting with a history of at-risk surgery (OR 2.3, 95%CI 1.1, 4.8, p = 0.03), presence of a tracheostomy (OR 3.1, 95%CI 1.0, 10.0, p = 0.04), or presence of a surgical feeding tube (OR 3.1, 95%CI 1.6, 6.2, p = 0.001) were more likely to present with VFMI. Routine screening for VFMI should be considered in all at-risk patients, regardless of symptoms or prior operations, particularly in those with a history of an at-risk surgery, presence of tracheostomy, or a surgical feeding tube. 3 Laryngoscope, 133:3564-3570, 2023.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3564-3570Informations de copyright
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
Références
Truong MT, Messner AH, Kerschner JE, et al. Pediatric vocal fold paralysis after cardiac surgery: rate of recovery and sequelae. Otolaryngol Head Neck Surg. 2007;137:780-784. https://doi.org/10.1016/j.otohns.2007.07.028.
Oestreicher-Kedem Y, DeRowe A, Nagar H, Fishman G, Ben-Ari J. Vocal fold paralysis in infants with tracheoesophageal fistula. Ann Otol Rhinol Laryngol. 2008;117:896-901. https://doi.org/10.1177/000348940811701206.
Benjamin JR, Smith PB, Cotten CM, Jaggers J, Goldstein RF, Malcolm WF. Long-term morbidities associated with vocal cord paralysis after surgical closure of a patent ductus arteriosus in extremely low birth weight infants. J Perinatol. 2010;30:408-413. https://doi.org/10.1038/jp.2009.124.
Morini F, Iacobelli BD, Crocoli A, et al. Symptomatic vocal cord paresis/paralysis in infants operated on for esophageal atresia and/or tracheo-esophageal fistula. J Pediatr. 2011;158:973-976. https://doi.org/10.1016/j.jpeds.2010.12.006.
Dewan K, Cephus C, Owczarzak V, Ocampo E. Incidence and implication of vocal fold paresis following neonatal cardiac surgery: VFP after neonate heart surgery. Laryngoscope. 2012;122:2781-2785. https://doi.org/10.1002/lary.23575.
Richter AL, Ongkasuwan J, Ocampo EC. Long-term follow-up of vocal fold movement impairment and feeding after neonatal cardiac surgery. Int J Pediatr Otorhinolaryngol. 2016;83:211-214. https://doi.org/10.1016/j.ijporl.2016.02.014.
Tibbetts KM, Wu D, Hsu JV, Burton WB, Nassar M, Tan M. Etiology and long-term functional swallow outcomes in pediatric unilateral vocal fold immobility. Int J Pediatr Otorhinolaryngol. 2016;88:179-183. https://doi.org/10.1016/j.ijporl.2016.07.008.
Pourmoghadam KK, DeCampli WM, Ruzmetov M, et al. Recurrent laryngeal nerve injury and swallowing dysfunction in neonatal aortic arch repair. Ann Thorac Surg. 2017;104:1611-1618. https://doi.org/10.1016/j.athoracsur.2017.03.080.
Crowson MG, Tong BC, Lee H-J, et al. Vocal fold paralysis/paresis as a marker for poor swallowing outcomes after thoracic surgery procedures. Dysphagia. 2019;34:904-915. https://doi.org/10.1007/s00455-019-09987-8.
Fung SW, Lapidus-Krol E, Chiang M, et al. Vocal cord dysfunction following esophageal atresia and tracheoesophageal fistula (EA/TEF) repair. J Pediatr Surg. 2019;54:1551-1556. https://doi.org/10.1016/j.jpedsurg.2018.08.041.
Henry BM, Hsieh WC, Sanna B, Vikse J, Taterra D, Tomaszewski KA. Incidence, risk factors, and comorbidities of vocal cord paralysis after surgical closure of a patent ductus arteriosus: A meta-analysis. Pediatr Cardiol. 2019;40:116-125. https://doi.org/10.1007/s00246-018-1967-8.
Steinberg JL, Khane GJ, Fernanades CMC, Nel JP. Anatomy of the recurrent laryngeal nerve: A redescription. J Laryngol Otol. 1986;100:919-927. https://doi.org/10.1017/S0022215100100325.
Liebermann-Meffert DM, Walbrun B, Hiebert CA, Siewert JR. Recurrent and superior laryngeal nerves: a new look with implications for the esophageal surgeon. Ann Thorac Surg. 1999;67:217-223. https://doi.org/10.1016/s0003-4975(98)01131-x.
Monfared A, Kim D, Jaikumar S, Gorti G, Kam A. Microsurgical anatomy of the superior and recurrent laryngeal nerves. Neurosurgery. 2001;49:925-932; discussion 932-933. https://doi.org/10.1097/00006123-200110000-00026.
Khalid A. Anatomy of the thoracic recurrent laryngeal nerves from a Surgeon's perspective. Anat Physiol. 2017;07:272. https://doi.org/10.4172/2161-0940.1000272.
Tabaee A, Murry T, Zschommler A, Desloge RB. Flexible endoscopic evaluation of swallowing with sensory testing in patients with unilateral vocal fold immobility: incidence and pathophysiology of aspiration. Laryngoscope. 2005;115:565-569. https://doi.org/10.1097/01.mlg.0000161358.20450.12.
Jabbour J, Martin T, Beste D, Robey T. Pediatric vocal fold immobility: natural history and the need for long-term follow-up. JAMA Otolaryngol Head Neck Surg. 2014;140:428. https://doi.org/10.1001/jamaoto.2014.81.
Gould FDH, Lammers AR, Ohlemacher J, et al. The physiologic impact of unilateral recurrent laryngeal nerve (RLN) lesion on infant oropharyngeal and esophageal performance. Dysphagia. 2015;30:714-722. https://doi.org/10.1007/s00455-015-9648-8.
Irace AL, Dombrowski ND, Kawai K, et al. Aspiration in children with unilateral vocal fold paralysis: pediatric aspiration and vocal fold paralysis. Laryngoscope. 2019;129:569-573. https://doi.org/10.1002/lary.27410.
Ohta N, Mori T. Vocal cord paralysis after surgery to the descending thoracic aorta via left posterolateral thoracotomy. Ann Vasc Surg. 2007;21:761-766. https://doi.org/10.1016/j.avsg.2007.06.003.
Schneider M, Dahm V, Passler C, et al. Complete and incomplete recurrent laryngeal nerve injury after thyroid and parathyroid surgery: characterizing paralysis and paresis. Surgery. 2019;166:369-374. https://doi.org/10.1016/j.surg.2019.05.019.
Gunn A, Oyekunle T, Stang M, Kazaure H, Scheri R. Recurrent laryngeal nerve injury after thyroid surgery: an analysis of 11,370 patients. J Surg Res. 2020;255:42-49. https://doi.org/10.1016/j.jss.2020.05.017.
Saito Y, Takeuchi H, Fukuda K, et al. Size of recurrent laryngeal nerve as a new risk factor for postoperative vocal cord paralysis. Dis Esophagus. 2018;31:1-8. https://doi.org/10.1093/dote/dox162.
Skinner ML, Halstead LA, Rubinstein CS, Atz AM, Andrews D, Bradley SM. Laryngopharyngeal dysfunction after the Norwood procedure. J Thorac Cardiovasc Surg. 2005;130:1293-1301. https://doi.org/10.1016/j.jtcvs.2005.07.013.
Strychowsky JE, Rukholm G, Gupta MK, Reid D. Unilateral vocal fold paralysis after congenital cardiothoracic surgery: A meta-analysis. Pediatrics. 2014;133:e1708-e1723. https://doi.org/10.1542/peds.2013-3939.
Woo S, Lau S, Yoo E, Shaul D, Sydorak R. Thoracoscopic versus open repair of tracheoesophageal fistulas and rates of vocal cord paresis. J Pediatr Surg. 2015;50:2016-2018. https://doi.org/10.1016/j.jpedsurg.2015.08.021.
Lal DR, Gadepalli SK, Downard CD, et al. Perioperative management and outcomes of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 2017;52:1245-1251. https://doi.org/10.1016/j.jpedsurg.2016.11.046.
Orzell S, Joseph R, Ongkasuwan J, Bedwell J, Shin J, Raol N. Outcomes of vocal fold motion impairment and dysphagia after pediatric cardiothoracic surgery: A systematic review. Otolaryngol Head Neck Surg. 2019;161:754-763. https://doi.org/10.1177/0194599819858594.
Rukholm G, Farrokhyar F, Reid D. Vocal cord paralysis post patent ductus arteriosus ligation surgery: risks and co-morbidities. Int J Pediatr Otorhinolaryngol. 2012;76:1637-1641. https://doi.org/10.1016/j.ijporl.2012.07.036.
Miyamoto RC, Parikh SR, Gellad W, Licameli GR. Bilateral congenital vocal cord paralysis: A 16-year institutional review. Otolaryngol Head Neck Surg. 2005;133:241-245. https://doi.org/10.1016/j.otohns.2005.02.019.
Mau T, Husain S, Sulica L. Pathophysiology of iatrogenic and idiopathic vocal fold paralysis may be distinct. Laryngoscope. 2020;130:1520-1524. https://doi.org/10.1002/lary.28281.
Ballester A, Gould F, Bond L, et al. Maturation of the coordination between respiration and deglutition with and without recurrent laryngeal nerve lesion in an animal model. Dysphagia. 2018;33:627-635. https://doi.org/10.1007/s00455-018-9881-z.
Pantvaidya G, Mishra A, Deshmukh A, Pai PS, D'Cruz A. Does the recurrent laryngeal nerve recover function after initial dysfunction in patients undergoing thyroidectomy? RLN recovery after thyroidectomy. Laryngoscope Investig Otolaryngol. 2018;3:249-252. https://doi.org/10.1002/lio2.167.
Meyer T, Hamelmann W, Timmermann W, Meyer B, Höcht B. The advantages and disadvantages of nerve monitoring during thyroid surgery in childhood. Eur J Pediatr Surg. 2006;16:392-395. https://doi.org/10.1055/s-2006-924738.
Meyer T, Höcht B. Recurrent laryngeal nerve monitoring during thyroid surgery in childhood. Eur J Pediatr Surg. 2006;16:149-154. https://doi.org/10.1055/s-2006-924219.
Propst EJ, Gorodensky J, Wasserman JD, Glazman EF, Tilis LA, Wolter NE. Recurrent laryngeal nerve monitoring with surface electrodes in pediatric thyroid surgery. Laryngoscope. 2020;130:1583-1589. https://doi.org/10.1002/lary.28250.
Lawlor CM, Zendejas B, Baird C, Munoz-San Julian C, Jennings RW, Choi SS. Intraoperative recurrent laryngeal nerve monitoring during pediatric cardiac and thoracic surgery: A mini review. Front Pediatr. 2020;8:791. https://doi.org/10.3389/fped.2020.587177.
Lawlor CM, Zendejas B, Julian CM, Meisner J, Jennings RW, Choi SS. Recurrent laryngeal nerve monitoring in pediatric surgery using a modified dragonfly electrode. Laryngoscope. 2021;131:2586-2589. https://doi.org/10.1002/lary.29505.
Ritter A, Hod R, Reuven Y, et al. Role of intraoperative recurrent laryngeal nerve monitoring for pediatric thyroid surgery: comparative analysis. Head Neck. 2021;43:849-857. https://doi.org/10.1002/hed.26544.
Lawlor CM, Meisner J, Jennings RW, Zendejas B, Choi SS. Comparative effectiveness of recurrent laryngeal nerve monitoring techniques in pediatric surgery. Laryngoscope. 2022;132:889-894. https://doi.org/10.1002/lary.29837.
Liu Y-CC, McElwee T, Musso M, Rosenberg TL, Ongkasuwan J. The reliability of flexible nasolaryngoscopy in the identification of vocal fold movement impairment in young infants. Int J Pediatr Otorhinolaryngol. 2017;100:157-159. https://doi.org/10.1016/j.ijporl.2017.07.005.
Ongkasuwan J, Yung KC, Courey MS. The physiologic impact of transnasal flexible endoscopy. Laryngoscope. 2012;122:1331-1334. https://doi.org/10.1002/lary.23358.
Demirci S, Tuzuner A, Callioglu EE, Akkoca O, Aktar G, Arslan N. Rigid or flexible laryngoscope: the preference of children. Int J Pediatr Otorhinolaryngol. 2015;79:1330-1332. https://doi.org/10.1016/j.ijporl.2015.06.004.
Wang LM, Zhu Q, Ma T, et al. Value of ultrasonography in diagnosis of pediatric vocal fold paralysis. Int J Pediatr Otorhinolaryngol. 2011;75:1186-1190. https://doi.org/10.1016/j.ijporl.2011.06.017.
Matta IR, Halan KB, Agrawal RH, Kalwari MS. Laryngeal ultrasound in diagnosis of vocal cord palsy: an underutilized tool? J Laryngol Voice. 2014;4:2. https://doi.org/10.4103/2230-9748.141439.
Ongkasuwan J, Ocampo E, Tran B. Laryngeal ultrasound and vocal fold movement in the pediatric cardiovascular intensive care unit. Laryngoscope. 2017;127:167-172. https://doi.org/10.1002/lary.26051.