TY - JOUR
T1 - Neonatal vocal fold paralysis
AU - Ryan, Marisa A.
AU - Upchurch, Patrick A.
AU - Senekki-Florent, Panayiota
N1 - Publisher Copyright:
© 2020, American Academy of Pediatrics. All rights reserved.
PY - 2020/5
Y1 - 2020/5
N2 - Vocal fold paralysis (VFP) is an important cause of respiratory and feeding compromise in infants. The causes of neonatal VFP are varied and include central nervous system disorders, birth-related trauma, mediastinal masses, iatrogenic injuries, and idiopathic cases. Bilateral VFP often presents with stridor or respiratory distress and can require rapid intervention to stabilize an adequate airway. Unilateral VFP presents more subtly with a weak cry, swallowingdysfunction,andless frequently respiratory distress. The etiology and type of VFP is important for management. Evaluation involves direct visualization of the vocal folds, with additional imagingandtestinginselectcases. Swallowing dysfunction, also known asdysphagia,isverycommonin infants with VFP. A clinical assessment of swallowing function is necessary in all cases of VFP, with some patients also requiring an instrumental swallow assessment. Modification of feeding techniques and enteral access for feedings may be necessary. Airway management can vary from close monitoring to noninvasive ventilation, tracheostomy, and laryngeal surgery. Long-term follow-up with otolaryngology and speech-language pathology service is necessary for all children with VFP to ensure adequate breathing, swallowing, and phonation. The short-and long-term health and quality-of-life consequences of VFP can be substantial, especially if not managed early.
AB - Vocal fold paralysis (VFP) is an important cause of respiratory and feeding compromise in infants. The causes of neonatal VFP are varied and include central nervous system disorders, birth-related trauma, mediastinal masses, iatrogenic injuries, and idiopathic cases. Bilateral VFP often presents with stridor or respiratory distress and can require rapid intervention to stabilize an adequate airway. Unilateral VFP presents more subtly with a weak cry, swallowingdysfunction,andless frequently respiratory distress. The etiology and type of VFP is important for management. Evaluation involves direct visualization of the vocal folds, with additional imagingandtestinginselectcases. Swallowing dysfunction, also known asdysphagia,isverycommonin infants with VFP. A clinical assessment of swallowing function is necessary in all cases of VFP, with some patients also requiring an instrumental swallow assessment. Modification of feeding techniques and enteral access for feedings may be necessary. Airway management can vary from close monitoring to noninvasive ventilation, tracheostomy, and laryngeal surgery. Long-term follow-up with otolaryngology and speech-language pathology service is necessary for all children with VFP to ensure adequate breathing, swallowing, and phonation. The short-and long-term health and quality-of-life consequences of VFP can be substantial, especially if not managed early.
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U2 - 10.1542/neo.21-5-e308
DO - 10.1542/neo.21-5-e308
M3 - Article
C2 - 32358144
AN - SCOPUS:85084215250
SN - 1526-9906
VL - 21
SP - e308-e322
JO - NeoReviews
JF - NeoReviews
IS - 5
M1 - e308
ER -