Sheen Derek, Houser Thomas K, Olsson Sofia E, Dabbous Helene, Kou Yann-Fuu, Johnson Romaine F, Chorney Stephen R
Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.
Burnett School of Medicine at Texas Christian University Fort Worth Texas USA.
OTO Open. 2024 Apr 30;8(2):e142. doi: 10.1002/oto2.142. eCollection 2024 Apr-Jun.
To determine whether injection laryngoplasty (IL) resolves thin liquid aspiration among children with unilateral vocal cord paralysis (UVCP) after cardiac surgery.
Retrospective case-control.
Tertiary children's hospital.
Consecutive children (<5 years) between 2012 and 2022 with UVCP after cardiac surgery were included. Resolution of thin liquid aspiration after IL versus observation was determined for children obtaining videofluoroscopic swallow studies (VFSS).
A total of 32 children with left UVCP after cardiac surgery met inclusion. Initial surgeries were N = 9 (28%) patent ductus arteriosus ligations, N = 7 (22%) aortic arch surgeries, N = 9 (28%) surgeries for hypoplastic left heart syndrome, and N = 7 (22%) other cardiac surgeries. The mean age at initial surgery was 1.8 months (SD: 3.7). All children had a VFSS obtained after surgery that confirmed aspiration. There were 17 children that obtained an IL at 33.6 months (SD: 20.9) after cardiac surgery and 15 children observed without IL procedure. No surgical complications after IL were noted. The rate of aspiration resolution based on postoperative VFSS was N = 14 (82%) for the IL group and N = 9 (60%) for the control group = .24. Documented VFSS aspiration resolution after cardiac surgery occurred by 9.6 months (SD: 10.0) in the observation group and 47.4 months (SD: 24.1) in the IL group ( < .001).
IL can help treat aspiration in children with UVCP after cardiac surgery but the benefit beyond observation remains unclear. Future studies should continue to explore the utility for IL in managing dysphagia in this pediatric population.
确定注射式喉成形术（IL）能否解决心脏手术后单侧声带麻痹（UVCP）患儿的稀薄液体误吸问题。
回顾性病例对照研究。
三级儿童医院。
纳入2012年至2022年间心脏手术后患有UVCP的连续儿童（<5岁）。对接受视频荧光吞咽造影检查（VFSS）的儿童，确定IL治疗后与观察等待相比稀薄液体误吸的解决情况。
共有32例心脏手术后左侧UVCP患儿符合纳入标准。初次手术包括9例（28%）动脉导管未闭结扎术、7例（22%）主动脉弓手术、9例（28%）左心发育不全综合征手术和7例（22%）其他心脏手术。初次手术时的平均年龄为1.8个月（标准差：3.7）。所有患儿术后均进行了VFSS检查，证实有误吸情况。17例患儿在心脏手术后33.6个月（标准差：20.9）接受了IL治疗，15例患儿未接受IL治疗而进行观察。未发现IL治疗后的手术并发症。根据术后VFSS，IL组误吸解决率为14例（82%），对照组为9例（60%），P = 0.24。观察组心脏手术后记录的VFSS误吸解决时间为9.6个月（标准差：10.0），IL组为47.4个月（标准差：24.1）（P < 0.001）。
IL有助于治疗心脏手术后UVCP患儿的误吸，但与观察等待相比其额外益处仍不明确。未来研究应继续探索IL在该儿科人群吞咽困难管理中的效用。
