ENT

Treatment of pediatric BVFP:

Treatment of pediatric BVFP:

Pediatric Bilateral Vocal Fold Paralysis (BVFP): o 2nd most common congenital laryngeal anomaly. o Accounts for more than 50% of all pediatric VFPs. o Less common in newborns than unilateral VFP.

Pediatric unilateral Vocal Fold Paralysis (VFP):

Pediatric Vocal Fold Paralysis (VFP)

Management of bilateral VCP: * Temporizing (Reversible) Treatment of BVFP * Long-Term Surgical Treatment of BVFP:

Initial Management of the Airway in bilateral VCP:

Management of Bilateral VFP: - Goal is to lateralize vocal fold for airway improvement without compromising voice and causing aspiration as possible. - Surgical interventions for BVFP cannot simultaneously result in improvement in airway without dysphonia(except Tracheostomy).

Clinical picture of bilateral VCP

DDx of bilateral VCP:

Causes of Bilateral Vocal Fold Paralysis (BVFP):

Bilateral vocal cord paralysis

Summary of Unilateral VCP

Type I Thyroplasty (Medialization Laryngoplasty) Arytenoid Adduction Reinnervation Procedures

Key differences between Injection Thyroplasty and Laryngeal Framework Surgery:

Injection Thyroplasty

Methods of Medialization Producers: 1. Injection Thyroplasty 2. Type I Thyroplasty 3. Arytenoid Adduction 4. Re-innervation Procedures

Early surgical intervention without waiting for conservative management is indicated for: 1. Clinical Aspiration 2. Vocal professional 3. Tran-section nerve injury 4. LEMG findings of poor prognosis

Management of Unilateral VFP: 1. Conservative with Speech Therapy 2. Surgical Intervention(Medialization Producers)

Laryngeal EMG: