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[儿童双侧声带麻痹的激光手术:2例报告及文献复习]

[Laser surgery for bilateral vocal cord paralysis in children: 2 cases report and literature review].

作者信息

Chen Chao, Zhou Yilong, Liu Dabo, Zhuang Peiyun

机构信息

Department of Otolaryngology,Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T,Shenzhen,510000,China.

Department of Pediatric Otorhinolaryngology,Shenzhen Hospital,Southern Medical University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Feb;39(2):173-176. doi: 10.13201/j.issn.2096-7993.2025.02.015.

Abstract

Vocal cord paralysis ( VCP ) refers to the movement disorder of the vocal cord caused by the damage of the motor nerve conduction pathway that dominates the laryngeal muscles, which can be accompanied by sensory nerve disorder of the larynx. Symptoms of bilateral vocal cord paralysis include crying hoarseness, sucking cough, and laryngeal stridor, which can lead to asphyxia in severe cases. Our team recently used CO2 laser to treat such children, but the prognosis varies significantly. Case 1: A 2-year-old male, who had undergone tracheotomy 2 years prior, was diagnosed with "bilateral vocal cord paralysis with grade Ⅱ laryngeal obstruction" after birth. He maintained a tracheostomy until recently. Electronic laryngoscopy showed that the bilateral vocal cords were fixed in the midline, with a glottic fissure of about 1 mm. After surgical treatment, the outcome was good, and there was no recurrence during follow-up. A 1-year-old female, who had undergone tracheotomy over a year ago, was diagnosed with ' ①bilateral vocal cord paralysis; ②laryngomalacia; ③neonatal pneumonia.' She maintained a tracheostomy since then. Electronic laryngoscopy revealed that the bilateral vocal cords were retracted and fixed, with a glottic fissure of about 0.5 mm and limited vocal cord abduction. The postoperative outcome for this child was not good, and the tracheostomy tube was not removed.

摘要

声带麻痹(VCP)是指支配喉肌的运动神经传导通路受损所引起的声带运动障碍,可伴有喉部感觉神经障碍。双侧声带麻痹的症状包括哭声嘶哑、吸吮性咳嗽和喉喘鸣,严重时可导致窒息。我们团队最近使用二氧化碳激光治疗此类患儿,但预后差异显著。病例1:一名2岁男性,2年前接受了气管切开术,出生后被诊断为“双侧声带麻痹伴Ⅱ度喉梗阻”。他一直维持气管切开状态直至最近。电子喉镜检查显示双侧声带固定于中线位,声门裂约1毫米。手术治疗后效果良好,随访期间无复发。一名1岁女性,1年多前接受了气管切开术,被诊断为“①双侧声带麻痹;②喉软化症;③新生儿肺炎”。此后她一直维持气管切开状态。电子喉镜检查显示双侧声带后缩并固定,声门裂约0.5毫米,声带外展受限。该患儿术后效果不佳,气管切开套管未拔除。

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[Laser surgery for bilateral vocal cord paralysis in children: 2 cases report and literature review].[儿童双侧声带麻痹的激光手术:2例报告及文献复习]
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本文引用的文献

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[The consensus among experts on the diagnosis and treatment of pediatric vocal cord paralysis].[小儿声带麻痹诊断与治疗专家共识]
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Pediatric Vocal Fold Paresis and Paralysis: A Narrative Review.小儿声带麻痹和瘫痪:叙述性综述。
JAMA Otolaryngol Head Neck Surg. 2021 Aug 1;147(8):745-752. doi: 10.1001/jamaoto.2021.1050.
5
Spontaneous recovery of bilateral congenital idiopathic laryngeal paralysis: systematic non-meta-analytical review.
Int J Pediatr Otorhinolaryngol. 2015 Feb;79(2):202-9. doi: 10.1016/j.ijporl.2014.12.007. Epub 2014 Dec 15.
7
Laser cordotomy for the treatment of bilateral vocal cord paralysis in infants.激光声带切开术治疗婴儿双侧声带麻痹
Int J Pediatr Otorhinolaryngol. 2009 Jan;73(1):9-13. doi: 10.1016/j.ijporl.2008.09.009. Epub 2008 Nov 18.
8
Bilateral vocal cord paralysis in children.儿童双侧声带麻痹
Otolaryngol Clin North Am. 2008 Oct;41(5):889-901, viii. doi: 10.1016/j.otc.2008.04.003.
10
Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis.
Laryngoscope. 1984 Oct;94(10):1293-7. doi: 10.1288/00005537-198410000-00006.

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