Trozzi Marilena, Meucci Duino, Salvati Antonio, Tropiano Maria Luisa, Bottero Sergio
Airway Surgery Unit, Pediatric Surgery Department, Bambino Gesù Children's Hospital, Rome, Italy.
Front Pediatr. 2020 Dec 9;8:538562. doi: 10.3389/fped.2020.538562. eCollection 2020.
Management of pediatric bilateral vocal cord palsy (BVCP) is a controversial and challenging topic. It may represent a severe obstructive condition usually associated with respiratory distress, and, in such condition, tracheostomy has been considered the gold standard for a long time. Many surgical options have been described and used to increase the glottic space in BVCP (1), with ongoing research of less invasive techniques. The challenge and current trend in our department and in many major pediatric centers is to avoid tracheotomy through an early treatment. Many techniques introduced in the last decade reduced the number of tracheotomies and increased the decannulation rate. Furthermore, we observed a recent increase in attention to preserve the quality of the voice with new techniques, such as endoscopic arytenoid abduction lateropexy which is in our opinion an important innovation to improve glottic space with satisfactory voice results. We present a review of the literature about the evolution of the treatment options for pediatric BVCP during the years.
小儿双侧声带麻痹（BVCP）的治疗是一个存在争议且具有挑战性的话题。它可能代表一种严重的阻塞性病症，通常与呼吸窘迫相关，在这种情况下，气管切开术长期以来一直被视为金标准。已经描述并使用了许多外科手术方法来增加BVCP患者的声门间隙（1），同时对侵入性较小的技术的研究也在不断进行。我们科室以及许多主要儿科中心面临的挑战和当前趋势是通过早期治疗避免气管切开术。过去十年中引入的许多技术减少了气管切开术的数量并提高了拔管率。此外，我们注意到最近人们越来越关注通过新技术来保留嗓音质量，比如内镜下杓状软骨外展固定术，我们认为这是一项重要的创新，可在改善声门间隙的同时获得令人满意的嗓音效果。我们对多年来小儿BVCP治疗选择的演变进行了文献综述。
