Experience with laryngeal reinnervation using nerve-muscle pedicle in pediatric patients.

Fayoux, Pierre; Maltezeanu, Alix; Broucqsault, Hélène; Daniel, Sam J.

Document type :

Article dans une revue scientifique: Article original

DOI :

10.1016/j.ijporl.2020.110254

PMID :

33137867

Permalink :

http://hdl.handle.net/20.500.12210/90507

Title :

Experience with laryngeal reinnervation using nerve-muscle pedicle in pediatric patients.

Author(s) :

Fayoux, Pierre [Auteur]

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Maltezeanu, Alix [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Broucqsault, Hélène [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Daniel, Sam J. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]

Journal title :

International Journal of Pediatric Otorhinolaryngology

Abbreviated title :

Int J Pediatr Otorhinolaryngol

Volume number :

138

Pages :

110254

Publication date :

2020-11-11

ISSN :

1872-8464

English keyword(s) :

Larynx
Reinnervation
Nerve-muscle pedicle
Pediatric
Vocal fold paralysis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective Vocal fold paralysis (VFP) in adducted position remains a challenge for airway surgeons. Alternatives to tracheostomies such as lateralization, cordectomy, and posterior rib grafting disrupt the laryngeal ...
Show more >Objective Vocal fold paralysis (VFP) in adducted position remains a challenge for airway surgeons. Alternatives to tracheostomies such as lateralization, cordectomy, and posterior rib grafting disrupt the laryngeal tissue or framework and carry an increased risk of aspiration. Laryngeal reinnervation using nerve-muscle pedicle (NMP), carries the distinct advantage of preserving the larynx, sparing the recurrent laryngeal nerve, and obtaining an active VF abduction. The aim of this study was to evaluate the success and complications of laryngeal reinnervation using nerve-muscle pedicle (NMP) in pediatric patients presenting with dyspnea related to VFP in adducted position. Methods In this case series performed at a tertiary care referral center, review of medical records on all pediatric patients with VFP in adduction treated with laryngeal reinnervation using NMP between 1999 and 2017. Data were collected on the preoperative flexible laryngoscopy, suspension micro-laryngoscopy, and laryngeal electromyography as well as post-operative clinical assessment of the voice and airway. All patients underwent surgery consisting of the transfer of an innervated omohyoid muscle pedicle onto the paralyzed posterior cricoarytenoid muscle. The main outcomes measured were the clinical and fiberoptic laryngoscopic airway assessment monthly for the first 6 months, then at 12 months and annually thereafter. Clinical assessment included dyspnea evaluation based on a visual analog scale and voice assessment using the GRBAS scores. Complications from the treatment were also noted. These outcomes were determined before collection of data. Results 16 cases were identified, with a mean age of 4 years. The recurrent laryngeal nerve paralysis was bilateral in 3 cases and unilateral in 13 cases. There were no peri or postoperative complications. After a mean follow-up of 7 years, vocal fold abduction was observed in 10 out of 16 cases and disappearance of paradoxical inspiratory adduction in 3 cases. Persistent dyspnea was noted in 7 cases (44%), and moderate dysphonia was present in 11 cases (69%). Finally, additional procedures were necessary in 2 patients (13%) to achieve the outcomes. Conclusions Laryngeal reinnervation using NMP may be used in pediatric patients. This procedure, is safe and allows us to spare the recurrent laryngeal nerve while obtaining an active VF abduction in the majority of cases, and an improvement in breathing in most cases.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T07:52:16Z
2024-01-08T09:42:38Z

Version	Link	Modification date
2	20.500.12210/90507*	2024-01-08T09:39:25Z
1	20.500.12210/90507.1	2023-11-15T07:52:16Z

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Experience with laryngeal reinnervation ...

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