Jabbour Jad, North Lauren M, Bougie David, Robey Thomas
1 Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
2 University of Wisconsin, Madison, Wisconsin, USA.
Otolaryngol Head Neck Surg. 2017 Dec;157(6):948-954. doi: 10.1177/0194599817726773. Epub 2017 Sep 5.
Objectives To describe the present understanding of birth trauma-related vocal fold immobility and quantitatively compare it with idiopathic congenital vocal fold immobility to explore whether it is a discrete entity. Data Sources PubMed, Ovid, and Cochrane databases. Review Methods English-language, observational, or experimental studies involving infants with idiopathic congenital or birth trauma-related vocal fold immobility were included. Data from these studies were pooled with our institution's vocal fold immobility database, with the resultant idiopathic congenital and birth trauma cohorts compared regarding patterns and outcomes of immobility. Results The search returned 288 articles, with 24 meeting inclusion criteria. Of studies reviewing all-cause immobility, 8 of 9 (88.9%) identified birth trauma as an etiology, although birth trauma definitions and proposed mechanisms of immobility varied. The study subjects, combined with our institution's database, yielded 188 idiopathic congenital and 113 birth trauma cases. Compared with idiopathic congenital cases, birth trauma cases had a higher proportion of unilateral immobility (72 of 113 [63.7%] vs 52 of 188 [27.7%], P < .001) and rate of resolution (41 of 51 [80.4%] vs 91 of 159 [57.2%], P = .003). Resolution occurred in 24 of 26 (91.3%) unilateral and 17 of 25 (68.0%) bilateral birth trauma cases and in 30 of 40 (75.0%) unilateral and 59 of 109 (54.1%) bilateral idiopathic congenital cases ( P = .11 and .20, respectively). Conclusion While the definition and mechanism of birth trauma-related vocal fold immobility warrant further investigation, these findings suggest that it is distinct from idiopathic congenital vocal fold immobility, with a unique presentation and potentially more favorable outcomes. This can inform counseling and management for infants with otherwise unexplained immobility but known birth trauma.
目的 描述目前对出生创伤相关声带麻痹的认识，并将其与特发性先天性声带麻痹进行定量比较，以探讨它是否为一个独立的实体。 数据来源 PubMed、Ovid和Cochrane数据库。 综述方法 纳入涉及特发性先天性或出生创伤相关声带麻痹婴儿的英文观察性或实验性研究。 这些研究的数据与我们机构的声带麻痹数据库汇总，对由此产生的特发性先天性和出生创伤队列的麻痹模式和结果进行比较。 结果 检索得到288篇文章，其中24篇符合纳入标准。 在审查所有原因导致的麻痹的研究中，9项研究中有8项（88.9%）将出生创伤确定为病因，尽管出生创伤的定义和提出的麻痹机制各不相同。 研究对象与我们机构的数据库相结合，产生了188例特发性先天性病例和113例出生创伤病例。 与特发性先天性病例相比，出生创伤病例单侧麻痹的比例更高（113例中的72例[63.7%]对188例中的52例[27.7%]，P <.001），缓解率更高（51例中的41例[80.4%]对159例中的91例[57.2%]，P =.003）。 26例单侧出生创伤病例中有24例（91.3%）和25例双侧出生创伤病例中有17例（68.0%）得到缓解，40例单侧特发性先天性病例中有30例（75.0%）和109例双侧特发性先天性病例中有59例（54.1%）得到缓解（P分别为.11和.20）。 结论 虽然出生创伤相关声带麻痹的定义和机制值得进一步研究，但这些发现表明它与特发性先天性声带麻痹不同，具有独特的表现，并且可能有更有利的结果。 这可以为患有无法解释的麻痹但有已知出生创伤的婴儿的咨询和管理提供参考。
