Abstract
Laryngeal surgery in children has advanced in the last 100 years. This has largely been due to developments in paediatric anaesthesia, diagnostic tools, microsurgical instruments and a multidisciplinary approach to the child’s larynx within a specialised paediatric institution.
The spectrum of laryngeal pathologies is different to that seen in adults and varies from neonates to infants to young to older children. Paediatric otolaryngologists manage such conditions as vocal cord nodules, laryngomalacia, subglottic stenosis and cysts, vocal cord paralysis and recurrent respiratory papillomatosis. On the other hand, adult otolaryngologists frequently encounter laryngitis, muscle tension dysphonia, spasmodic dysphonia, vocal cord paralysis, vocal cord polyps, nodules or cysts (non-cancerous lesions) and pre-cancerous and cancerous lesions. Most paediatric laryngeal disorders can be managed surgically with endoscopic minimally invasive techniques. The aim of this chapter is to discuss the advances in the diagnosis and management of the majority of laryngeal disorders encountered by a paediatric otolaryngologist. The laryngeal assessment, anaesthetic considerations and 13 different pathological disorders are presented.
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References
Daniel M, Cheng A. Neonatal stridor. Int J Pediatr. 2012;2012:859104.
Ongkasuwan J, et al. Laryngeal ultrasound and vocal fold movement in the pediatric cardiovascular intensive care unit. Laryngoscope. 2017;127(1):167–72.
Smillie I, et al. The paediatric voice clinic. Arch Dis Child. 2014;99(10):912–5.
Ongkasuwan J, et al. Transoral rigid 70-degree laryngoscopy in a pediatric voice clinic. Laryngoscope. 2019;129(7):1657–9.
Zur KB, et al. Pediatric Voice Handicap Index (pVHI): a new tool for evaluating pediatric dysphonia. Int J Pediatr Otorhinolaryngol. 2007;71(1):77–82.
Lauder G, et al. Volatiles or TIVA: which is the standard of care for pediatric airway procedures? A pro-con discussion. Pediatr Anesth. 2020;30(3):209–20.
Londino A, Jagannathan N. Anesthesia in diagnostic and therapeutic pediatric bronchoscopy. Otolaryngol Clin N Am. 2019;52(6):1037–48.
Karsli C. Managing the challenging pediatric airway: continuing professional development. Can J Anesth. 2015;62(9):1000–16.
Landry A, Thompson D. Laryngomalacia: disease presentation, spectrum, and management. Int J Pediatr. 2012;2012:1–6.
Olney D, et al. Laryngomalacia and its treatment. Laryngoscope. 1999;109(11):1770–5.
Carter J, et al. International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations. Int J Pediatr Otorhinolaryngol. 2016;86:256–61.
Del Do M, et al. Supraglottoplasty surgery types 1–3: a practical classification system for laryngomalacia surgery. Int J Pediatr Otorhinolaryngol. 2018;111:69–74.
Parkes W, Propst E. Advances in the diagnosis, management, and treatment of neonates with laryngeal disorders. Semin Fetal Neonatal Med. 2016;21(4):270–6.
Daya H, et al. Pediatric vocal fold paralysis. Arch Otolaryngol Head Neck Surg. 2000;126(1):21.
Lesnik M, et al. Idiopathic bilateral vocal cord paralysis in infants: case series and literature review. Laryngoscope. 2014;125(7):1724–8.
Cohen J, Benyamini L. Voice outcome after vocal fold injection augmentation with carboxymethyl cellulose versus calcium hydroxyapatite. J Laryngol Otol. 2020;134(3):263–9.
Marie JP, et al. Nonselective reinnervation as a primary or salvage treatment of unilateral vocal fold palsy. Laryngoscope. 2020;130(7):1756–63.
Bouhabel S, Hartnick CJ. Current trends in practices in the treatment of pediatric unilateral vocal fold immobility: a survey on injections, thyroplasty and nerve reinnervation. Int J Pediatr Otorhinolaryngol. 2018;109:115–8.
Butskiy O, et al. Surgical interventions for pediatric unilateral vocal cord paralysis: a systematic review. JAMA Otolaryngol Head Neck Surg. 2015;141(7):654–60.
Rutter M, et al. Endoscopic anterior-posterior cricoid split for pediatric bilateral vocal fold paralysis. Laryngoscope. 2017;128(1):257–63.
Dahl J, et al. Endoscopic posterior cricoid split with costal cartilage graft: a fifteen-year experience. Laryngoscope. 2016;127(1):252–7.
Funk R, et al. Factors associated with tracheotomy and decannulation in pediatric bilateral vocal fold immobility. Int J Pediatr Otorhinolaryngol. 2015;79(6):895–9.
Montague GL, Bly RA, Nadaraja GS, Conrad DE, Parikh SR, Chan DK. Endoscopic percutaneous suture lateralization for neonatal bilateral vocal fold immobility. Int J Pediatr Otorhinolaryngol. 2018;108:120–4.
Chen E, Inglis A. Bilateral vocal cord paralysis in children. Otolaryngol Clin N Am. 2008;41(5):889–901.
Lee J, et al. Bilateral selective laryngeal reinnervation for bilateral vocal fold paralysis in children. JAMA Otolaryngol Head Neck Surg. 2020;146(5):401.
Marina M, et al. Laryngeal reinnervation for bilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg. 2011;19(6):434–8.
Myer CM III, et al. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol. 1994;103(4):319–23.
Leung R, Berkowitz RG. Incidence of severe acquired subglottic stenosis in newborns. Int J Pediatr Otorhinolaryngol. 2007;71(5):763–8.
Rutter M, Kuo I. Predicting and managing the development of subglottic stenosis following intubation in children. J Pediatr. 2020;96(1):1–3.
Sekioka A, et al. Serial intralesional triamcinolone acetonide injections for acquired subglottic stenosis in premature infants. Pediatr Surg Int. 2018;34(10):1047–52.
Yung KC, et al. A randomized controlled trial of adjuvant mitomycin-c in endoscopic surgery for laryngotracheal stenosis. Laryngoscope. 2020;130(3):706–11.
Bakthavachalam S, McClay JE. Endoscopic management of subglottic stenosis. Otolaryngol Head Neck Surg. 2008;139(4):551–9.
George M, et al. Management of severe pediatric subglottic stenosis with glottic involvement. J Thorac Cardiovasc Surg. 2010;139(2):411–7.
Lim J, et al. Subglottic cysts: the Great Ormond street experience. Int J Pediatr Otorhinolaryngol. 2003;67(5):461–5.
Steehler MK, et al. Management of subglottic cysts with Mitomycin-C—a case series and literature review. Int J Pediatr Otorhinolaryngol. 2011;75(3):360–3.
Hoff SR, Koltai PJ. Operative management of juvenile-onset recurrent respiratory papillomatosis. Oper Tech Otolaryngol Head Neck Surg. 2012;23(2):117–23.
Novakovic D, et al. A prospective study of the incidence of juvenile-onset recurrent respiratory papillomatosis after implementation of a national HPV vaccination program. J Infect Dis. 2018;217(2):208–12.
Lawlor C, et al. International Pediatric Otolaryngology Group (IPOG): juvenile-onset recurrent respiratory papillomatosis consensus recommendations. Int J Pediatr Otorhinolaryngol. 2020;128:109697.
Derkay CS, et al. A staging system for assessing severity of disease and response to therapy in recurrent respiratory papillomatosis. Laryngoscope. 1998;108(6):935–7.
Wiatrak BJ, et al. Recurrent respiratory papillomatosis: a longitudinal study comparing severity associated with human papilloma viral types 6 and 11 and other risk factors in a large pediatric population. Laryngoscope. 2004;114(S104):1–23.
Chadha NK, James A. Adjuvant antiviral therapy for recurrent respiratory papillomatosis. Cochrane Database Syst Rev. 2010;12(12):CD005053.
Birchall MA, Carding P. Vocal nodules management. Clin Otolaryngol. 2019;44(4):497–501.
Cohen W, et al. Development of a minimum protocol for assessment in the paediatric voice clinic. Part 1: Evaluating vocal function. Logopedics Phoniatrics Vocol. 2012;37(1):33–8.
Ongkasuwan J, Friedman EM. Is voice therapy effective in the management of vocal fold nodules in children? Laryngoscope. 2013;123(12):2930–1.
Martins RHG, et al. Clinical practice: vocal nodules in dysphonic children. Eur J Pediatr. 2013;172(9):1161–5.
Hartnick C, et al. Indirect vs direct voice therapy for children with vocal nodules: a randomized clinical trial. JAMA Otolaryngol Head Neck Surg. 2018;144(2):156–63.
Avelino MAG, et al. Congenital laryngeal webs: from diagnosis to surgical outcomes. Braz J Otorhinolaryngol. 2020; https://doi.org/10.1016/j.bjorl.2020.06.018.
Fussey JM, et al. Surgical management of acquired anterior glottic web: a systematic review. J Laryngol Otol. 2019;133(10):867–74.
Chiang T, et al. Surgical management of type I and II laryngeal cleft in the pediatric population. Int J Pediatr Otorhinolaryngol. 2014;78(12):2244–9.
Yeung JC, et al. International Pediatric Otolaryngology Group: consensus guidelines on the diagnosis and management of type I laryngeal clefts. Int J Pediatr Otorhinolaryngol. 2017;101:51–6.
Fraga JC, et al. The association between laryngeal cleft and tracheoesophageal fistula: myth or reality? Laryngoscope. 2015;125(2):469–74.
Johnston DR, et al. Laryngeal cleft: evaluation and management. Int J Pediatr Otorhinolaryngol. 2014;78(6):905–11.
Raol N, et al. Propranolol for the treatment of subglottic hemangiomas. Int J Pediatr Otorhinolaryngol. 2011;75(12):1510–4.
Léauté-Labrèze C, et al. Propranolol for severe hemangiomas of infancy. N Engl J Med. 2008;358(24):2649–51.
Hardison S, et al. The use of propranolol in the treatment of subglottic hemangiomas: a literature review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2016;90:175–80.
Darrow DH. Management of infantile hemangiomas of the airway. Otolaryngol Clin N Am. 2018;51(1):133–46.
Li Y, et al. Vallecular cyst in the pediatric population: evaluation and management. Int J Pediatr Otorhinolaryngol. 2018;113:198–203.
Butler CR, et al. Endoscopic airway management of laryngeal sarcoidosis. Arch Otolaryngol Head Neck Surg. 2010;136(3):251–5.
Kelleher KJ, et al. Treatment-recalcitrant laryngeal sarcoidosis responsive to sirolimus. BMJ Case Rep. 2020;13(8):e235372.
Eustaquio ME, et al. Multilevel airway involvement in children with Wegener’s granulomatosis: clinical course and the utility of a multidisciplinary approach. Arch Otolaryngol Head Neck Surg. 2011;137(5):480–5.
Rahbar R, et al. The biology and management of laryngeal neurofibroma. Arch Otolaryngol Head Neck Surg. 2004;130(12):1400–6.
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Lang, B., Mehanna, R., Russell, J. (2022). Laryngeal Surgery in Children. In: Remacle, M., Eckel, H.E. (eds) Textbook of Surgery of Larynx and Trachea. Springer, Cham. https://doi.org/10.1007/978-3-031-09621-1_13
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DOI: https://doi.org/10.1007/978-3-031-09621-1_13
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