Stack Taylor J, Carrasco Maria C, Shah Joel, Zdanski Carlton J, Roberts Jason
Department of Otolaryngology-Head & Neck Surgery University of North Carolina Chapel Hill North Carolina USA.
Asheville Ear Nose & Throat Asheville North Carolina USA.
Laryngoscope Investig Otolaryngol. 2023 Aug 16;8(5):1421-1427. doi: 10.1002/lio2.1132. eCollection 2023 Oct.
Type 1 laryngeal clefts (LC1) and deep interarytenoid grooves contribute to pediatric feeding disorders. Management of these defects remains heterogeneous among surgeons and interarytenoid injection augmentation (IIA) is not always offered as a treatment option. This study evaluated IIA outcomes among a pediatric patient cohort comprised mostly of those with deep interarytenoid grooves.
A single-institution retrospective chart review featured children under the age of 5 years presenting for aspiration, dysphagia, or choking. Over the period of 7 years (January 2014-October 2021), 39 met inclusion criteria and had sufficient follow-up data. Descriptive statistics and subgroup analyses were performed.
Of the 39 included patients, 76.92% had clinical improvement post-injection, with the mean time to follow-up being 47 days. Within the deep interarytenoid groove group, improvement rates were 82.76%. Bronchoscopy findings revealed 29 (74.36%) patients with a DIG, 3 (7.69%) with LC1, 3 (7.69%) with no anatomic abnormality, and 4 (10.26%) with vocal cord paralysis. There were no adverse events. There were no associations with the outcomes based on subgroup analysis and logistic regression.
IIA is an effective and safe treatment for pediatric feeding disorders. No covariates were associated with symptom improvement. Within the deep interarytenoid groove diagnosis subgroup, IIA effectively improved symptoms. Further investigations are needed to explore predictors of success with IIA in this population.
VI.
1型喉裂（LC1）和杓间深部沟导致小儿喂养障碍。这些缺陷的治疗在外科医生中仍存在差异，杓间注射填充术（IIA）并非总是作为一种治疗选择。本研究评估了主要由患有杓间深部沟的患儿组成的儿科患者队列中IIA的治疗效果。
一项单机构回顾性病历审查纳入了5岁以下因误吸、吞咽困难或呛噎就诊的儿童。在7年期间（2014年1月至2021年10月），39名患者符合纳入标准并拥有足够的随访数据。进行了描述性统计和亚组分析。
在39名纳入患者中，76.92%在注射后临床症状改善，平均随访时间为47天。在杓间深部沟组中，改善率为82.76%。支气管镜检查结果显示，29名（74.36%）患者有杓间深部沟，3名（7.69%）有LC1，3名（7.69%）无解剖异常，4名（10.26%）有声带麻痹。无不良事件发生。基于亚组分析和逻辑回归，未发现与治疗效果相关的因素。
IIA是治疗小儿喂养障碍的一种有效且安全的方法。没有协变量与症状改善相关。在杓间深部沟诊断亚组中，IIA有效改善了症状。需要进一步研究以探索该人群中IIA成功治疗的预测因素。
VI级。
