目的:本文回顾了目前有关流行病学的文献,病因,诊断,小儿双侧声带麻痹(PBVFP)的治疗。
方法:根据PRISMA声明,通过PubMed对当前文献进行了叙述性审查,Scopus,和Cochrane图书馆关于流行病学的数据库,病因,诊断,和PBVFP的管理。
结果:PBVCP是儿科人群中第二常见的先天性喉畸形,占小儿喉部疾病的10%至20%。PBVCP与特发性(42.2%)有关,先天性(19.7%),和神经系统(16.9%)条件。60%的喘鸣和呼吸困难病例需要进行气管切开术,这是最常见的症状。诊断基于病因特征,临床表现,喉镜检查结果,客观的考试。喉肌电图可用于支持疑难病例的诊断,但它的可靠性取决于从业者的经验。主要鉴别诊断为后声门狭窄,需要排除与PBVCP的治疗和管理差异。瞬时外科手术包括气管切开术或声带的后部固定。目前的永久性手术包括单-或双侧部分软骨切除术,后横切下索切开术,环状软骨分裂,和喉选择性神经支配。没有证据表明某些程序优于其他程序。
结论:PBVCP是儿科人群中第二常见的喉部疾病。诊断基于病因和临床发现,可能需要使用喉部肌电图。治疗管理可能涉及几个短暂或永久的外科手术,与症状的整体主观改善有关。喉部的发现,并发症发生率低。
OBJECTIVE: This paper reviews the current literature about epidemiology, etiologies, diagnosis, and management of pediatric bilateral vocal fold paralysis (PBVFP).
METHODS: According to PRISMA statements, a narrative review of the current literature was conducted through the PubMed, Scopus, and Cochrane Library databases about the epidemiology, etiologies, diagnosis, and management of PBVFP.
RESULTS: PBVCP is the second most common congenital laryngeal anomaly in the pediatric population, accounting for 10% to 20% of pediatric laryngeal conditions. PBVCP is related to idiopathic (42.2%), congenital (19.7%), and neurological (16.9%) conditions. A tracheotomy is required in 60% of cases regarding stridor and dyspnea, which are the most prevalent symptoms. The diagnosis is based on the etiological features, clinical presentation, laryngoscopic findings, and objective examinations. Laryngeal electromyography may be used to support the diagnosis in difficult cases, but its reliability depends on the practitioner\'s experience. The primary differential diagnosis is posterior glottis stenosis, which needs to be excluded regarding therapeutic and management differences with PBVCP. Transient surgical procedures consist of tracheotomy or laterofixation of the vocal fold. Current permanent procedures include uni- or bilateral partial arytenoidectomy, posterior transverse cordotomy, cricoid splits, and laryngeal selective
reinnervation. There is no evidence of the superiority of some procedures over others.
CONCLUSIONS: PBVCP is the second most common laryngeal disorder in the pediatric population. Diagnosis is based on etiological and clinical findings and may require the use of laryngeal electromyography. Therapeutic management may involve several transient or permanent surgical procedures that are associated with overall subjective improvements in symptoms, laryngeal findings, and low complication rates.