Scatolini María Laura, Rodriguez Hugo A, Pérez Cinthia G, Cocciaglia Alejandro, Botto Hugo A, Nieto Mary, Bordino Lucas
Servicio de Endoscopía Respiratoria, Hospital de Pediatría Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
Servicio de Endoscopía Respiratoria, Hospital de Pediatría Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
Acta Otorrinolaringol Esp (Engl Ed). 2018 Sep-Oct;69(5):297-303. doi: 10.1016/j.otorri.2017.10.003. Epub 2018 Mar 23.
Bilateral vocal cord paralysis (BVCP) is the second most common cause of neonatal stridor. The aim of this study was to describe the demographic features, aetiology, comorbidities, and management of our patients with BVCP.
We conducted a retrospective review of the clinical charts of all patients diagnosed with BVCP seen at the Department of Respiratory Endoscopy between 2011 and 2015.
47 patients were included. Mean age at diagnosis was 1 month and male sex predominated (63%). The aetiology was congenital in 59% and acquired in 41% of the infants. The cause was most frequently idiopathic in the former group and secondary to postoperative injury in the latter. Overall, 42 patients (89%) required tracheostomy, without statistically significant differences between the causes. Of all the patients, 39% regained vocal-cord mobility; 44% of those with congenital BVCP, 31% of those with acquired BVCP and 62.5% with idiopathic BVCP. In five patients a laryngotracheoplasty was performed with a posterior costal cartilage graft and one underwent posterior cordectomy. All were decannulated. In one patient vocal-cord lateralization was performed, avoiding tracheostomy.
BVCP was most commonly of congenital cause and was mainly idiopathic within this group of patients, with a slight male preponderance. A high percentage of patients required tracheostomy. A higher recovery rate of vocal-cord mobility was observed in idiopathic BVCP, which allowed for successful decannulation. In this series, decannulation was possible in all patients that underwent surgery; however, further studies with comparison of techniques and objective assessment of swallowing and phonation are necessary.
双侧声带麻痹（BVCP）是新生儿喘鸣的第二大常见病因。本研究的目的是描述我们的BVCP患者的人口统计学特征、病因、合并症及治疗情况。
我们对2011年至2015年间在呼吸内镜科诊断为BVCP的所有患者的临床病历进行了回顾性研究。
纳入47例患者。诊断时的平均年龄为1个月，男性占主导（63%）。59%的婴儿病因是先天性的，41%是后天性的。前一组病因最常见为特发性，后一组继发于术后损伤。总体而言，42例患者（89%）需要气管切开术，不同病因之间无统计学显著差异。所有患者中，39%恢复了声带活动度；先天性BVCP患者中44%恢复，后天性BVCP患者中31%恢复，特发性BVCP患者中62.5%恢复。5例患者进行了带后肋软骨移植的喉气管成形术，1例进行了后索切除术。所有患者均拔管。1例患者进行了声带外移术，避免了气管切开术。
BVCP最常见的病因是先天性的，在这组患者中主要是特发性的，男性略占优势。高比例患者需要气管切开术。特发性BVCP患者声带活动度恢复率较高，这使得成功拔管成为可能。在本系列中，所有接受手术的患者均有可能拔管；然而，需要进一步比较技术并对吞咽和发声进行客观评估的研究。
