Georgopoulos Rachel, Arianpour Khashayar, Anne Samantha
Head and Neck Institute - Cleveland Clinic, Cleveland, Ohio, USA.
Otolaryngol Head Neck Surg. 2025 Sep;173(3):731-737. doi: 10.1002/ohn.1281. Epub 2025 May 5.
This study aims to determine the incidence and prognosis of dysphagia in pediatric patients with true vocal fold (TVF) immobility or hypomobility.
A single-center retrospective chart review.
A single-institution tertiary-care center.
A total of 89 pediatric patients diagnosed with vocal fold hypo/immobility with a modified barium swallow (MBS) performed were examined. Patient demographic information and etiology of vocal fold immobility as well as laterality were reviewed. Changes in MBS findings over time were assessed.
A total of 89 pediatric patients were identified with a mean follow-up of 35.4 months. The most common etiology of TVF hypo/immobility was cardiothoracic surgery (58.4%).Immobility was observed in 80.6% of patients. Patients with unilateral disease were more likely to present with dysphonia than bilateral disease (40.3% vs 9.1%, odds ratio [OR] 6.75, 95% confidence interval [CI] 1.77-44.5, P = .01). MBS results did not vary statistically with respect to laterality, hypomobility versus immobility, or etiology. Of the 33 children who demonstrated aspiration on their initial MBS, 48.5% demonstrated complete resolution over median of 10.5 weeks. Rates of recovery differed only with respect to hypomobility versus immobility (87.5% vs 33.3%, OR 14.0, 95% CI 2.01-286, P = .0133).
Based on the study results, about half of pediatric patients with vocal fold hypo/immobility will have resolution of dysphagia at about 10.5 weeks. This may helpful when deciding on when to obtain follow up imaging/exam on pediatric patients with dysphagia. The only factor that confers improved prognosis is hypomobility when compared to complete immobility.
本研究旨在确定小儿真性声带（TVF）固定或活动减弱患者吞咽困难的发生率及预后情况。
单中心回顾性病历审查。
一家单机构三级医疗中心。
共检查了89例经改良钡餐吞咽造影（MBS）诊断为声带活动减弱/固定的小儿患者。回顾了患者的人口统计学信息、声带固定的病因以及病变侧别。评估了MBS检查结果随时间的变化情况。
共确定89例小儿患者，平均随访35.4个月。TVF活动减弱/固定最常见的病因是心胸外科手术（58.4%）。80.6%的患者存在声带固定。单侧病变患者比双侧病变患者更易出现声音嘶哑（40.3%对9.1%，优势比[OR]6.75，95%置信区间[CI]1.77 - 44.5，P = 0.01）。MBS结果在病变侧别、活动减弱与固定、病因方面无统计学差异。在初次MBS检查显示有误吸的33例儿童中，48.5%在中位时间10.5周时显示完全缓解。恢复率仅在活动减弱与固定方面存在差异（87.5%对33.3%，OR 14.0，95% CI 2.01 - 286，P = 0.0133）。
根据研究结果，约一半声带活动减弱/固定的小儿患者在约10.5周时吞咽困难会得到缓解。这在决定何时对吞咽困难的小儿患者进行后续影像学检查/评估时可能会有帮助。与完全固定相比，唯一能改善预后的因素是活动减弱。
