The Journal of Laryngology & Otology



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Laser arytenoidectomy in children with bilateral vocal fold immobility


Worley a1 , Bajaj a1c1 , Cavalli a1 and Hartley a1
a1 Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London, UK

Article author query
worley g   [PubMed][Google Scholar] 
bajaj y   [PubMed][Google Scholar] 
cavalli l   [PubMed][Google Scholar] 
hartley b   [PubMed][Google Scholar] 

Abstract

Bilateral vocal fold immobility in children is a challenging problem because a balance between good airway and voice quality has to be achieved. Surgery to improve the airway is often postponed or avoided because of fear of losing the voice. In this study our results of laser arytenoidectomy in children are described. This was a retrospective case notes review at a tertiary level paediatric ENT department. The six patients in this case series ranged from nine to 16 years old at the time of laser arytenoidectomy. Post-operative airway and voice quality were assessed. All children in the series had an adequate post-operative airway. Four of these patients had tracheostomies pre-operatively and achieved decannulation. All six patients rated their post-operative voice as better than pre-operatively. This is principally due to increased loudness associated with increased airflow through the larynx, particularly after tracheostomy decannulation. It is recommended that special care should be taken not to disturb the anterior two thirds of the vocal fold during the surgery in order to achieve a good post-operative voice outcome.

(Published Online June 9 2006)
(Accepted February 28 2006)


Key Words: Arytenoidectomy; Larynx Surgical Procedures; Laser; Children; Voice.

Correspondence:
c1 Address for correspondence: Mr Yogesh Bajaj, 2, Tall Trees, Leeds LS17 7WA. Fax: 00 44 (0)113 266 3305 Email: ybajaj@hotmail.co.uk


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