Programa de Fellowship do Serviço de Otorrinolaringologia (ORL) Pediátrica do Hospital da Criança Santo Antônio (HCSA)/ Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA).
Programa de Fellowship do Serviço de Otorrinolaringologia (ORL) Pediátrica do Hospital da Criança Santo Antônio (HCSA)/ Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA).
Braz J Otorhinolaryngol. 2024 Sep-Oct;90(5):101469. doi: 10.1016/j.bjorl.2024.101469. Epub 2024 Jul 14.
Percutaneous Vocal Fold Lateralization (PVFL) consists of external fixation with non-absorbable percutaneous suture of the vocal fold in a lateral position, under direct glottic visualization. The objective of this study is to determine the effectiveness of PVFL in a university pediatric hospital, as well as to describe the potential risks and complications of the surgery.
Retrospective cohort study, with data collected from electronic medical records. The study was approved by the Research Ethics Committee of the institution. Surgeries were performed with the modified Lichentenberg technique and data, and outcomes were analyzed.
Six patients with Bilateral Vocal Fold Paralysis who underwent Percutaneous Vocal Fold Lateralization were evaluated. Three patients were male. The age at diagnosis ranged from 2 to 132 days (mean 10.5 days). The reason for investigating the upper airway was the presence of increased work of breathing and stridor. Five patients had a favorable clinical evolution, with spontaneous ventilation in room air and absence of stridor or ventilatory effort, without the need for tracheostomy. Surgical results in this series corroborate the findings of other similar cohorts, which showed Percutaneous Vocal Fold Lateralization as a safe and effective procedure in avoiding tracheostomy or allowing decannulation in children with Bilateral Vocal Fold Paralysis.
PVFL seems to be a safe and effective procedure, but it has morbidity, due to immediate, and probably late, non-serious complications. Studies with a larger number of patients, with longer follow-up and using a controlled and randomized clinical design are needed to establish the role of PVFL in the treatment of BVFP in newborns and infants.
Level 4 (step 4).
经皮声带外侧移位术（PVFL）包括在直接喉镜下将声带外侧的不可吸收经皮缝线固定，使声带处于外侧位置。本研究的目的是确定大学儿科医院中 PVFL 的有效性，并描述手术的潜在风险和并发症。
回顾性队列研究，从电子病历中收集数据。该研究得到了机构研究伦理委员会的批准。手术采用改良的 Lichentenberg 技术进行，并对数据和结果进行分析。
评估了 6 例接受经皮声带外侧移位术的双侧声带麻痹患者。3 例为男性。诊断时的年龄为 2 至 132 天（平均 10.5 天）。调查上呼吸道的原因是呼吸功增加和喘鸣。5 例患者的临床转归良好，可在室内空气下自主通气，无喘鸣或呼吸努力，无需气管切开。本系列的手术结果与其他类似队列的研究结果一致，表明经皮声带外侧移位术是一种安全有效的方法，可避免气管切开或允许双侧声带麻痹的儿童拔管。
PVFL 似乎是一种安全有效的手术方法，但它有一定的发病率，因为会出现即刻和可能迟发的非严重并发症。需要进行更多患者、更长随访时间的研究，并采用对照和随机临床设计，以确定 PVFL 在新生儿和婴儿中治疗双侧声带麻痹的作用。
4 级（第 4 步）。
