OBJECTIVE: To compare practices of the American Broncho-Esophagological Association (ABEA) membership regarding the evaluation and management of unilateral vocal fold motion impairment (UVFMI) in adult versus pediatric populations.
STUDY DESIGN AND SETTING: An 18-item adult survey and 16-item pediatric survey were administered to ABEA members.
RESULTS: Seventy-six adult (31%) and 35 pediatric surveys (43%) were completed. Key differences are highlighted. With respect to etiology, the most common reported childhood cause is idiopathic; adults more often suffer iatrogenic paralysis. Children more commonly experience reflux disease, feeding difficulties, and choking. Preferred testing involves flexible laryngoscopy and chest x-ray; however, laboratory tests are carried out less often in children (51% vs 71%) and medical intervention is advocated by fewer pediatric practitioners (39% vs 57%).
CONCLUSION: Significant disparities exist in the etiology, presenting symptoms, diagnostic testing, and medical treatment between children and adults with UVFMI.
SIGNIFICANCE: Clinicians' perceptions regarding UVFMI may reflect the differing impact of vocal paralysis in the pediatric versus adult populations.
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References
1.
ParikhSR. Pediatric unilateral vocal fold immobilityOtolaryngol Clin N Am2004;37:203–15
2.
GentileRDMillerRHWoodsonGE. Vocal cord paralysis in children 1 year of age and youngerAnn Otol Rhinol Laryngol1986;95:622–5
3.
BenningerMSGillenJBAltmanJS. Changing etiology of vocal fold immobilityLaryngoscope1998;108:1346–50
4.
RichardsonBEBastianRW. Clinical evaluation of vocal fold paralysisOtolaryngol Clin N Am2004;37:45–58
5.
HalumSLPatelNSmithT. Laryngeal electromyography for adult unilateral vocal fold immobility: a survey of the American Broncho-Esophageal AssociationAnn Otol Rhinol Laryngol2005;114:425–8
6.
IshmanSLHalumSLKerschnerJE. Contemporary management of pediatric vocal paralysis: a survey of the ABEA membership. American Broncho-Esophagological Association Annual Meeting, Boca Raton, FL, May 2005
7.
DayaHHosniABejar-SolarI. Pediatric vocal fold paralysis: a long-term retrospective studyArch Otolaryngol Head Neck Surg2000;126:21–5
8.
EmeryPJFearonB. Vocal cord palsy in pediatric practice: a review of 71 casesInt J Pediatric Otorhinolaryngol1984;8:147–54
9.
AltmanKWWetmoreRFMarshRR. Congenital airway abnormalities requiring tracheostomy: a profile of 56 patients and their diagnosis over a 9-year periodInt J Pediatr Otorhinolaryngol1997;41:199–206
10.
TillesSA. Vocal cord dysfunction in children and adolescentsCurr Allergy Asthma Rep2003;3:467–72
11.
GoldBD. Gastroesophageal reflux disease: could intervention in childhood reduce the risks of later complications?Am J Med 1004;117(Suppl):23S–9S
12.
TerrisDArnsteinDNguyenH. Contemporary evaluation of unilateral vocal cord paralysisOtolaryngol Head Neck Surg1992;107:84–90
13.
PatelNJKerschnerJEMeratiAL. The use of injectable collagen in the management of pediatric vocal unilateral fold paralysisInt J Pediatr Otorhinolaryngol2003;67:1355–60
