title: The use of injectable collagen in the management of pediatric vocal unilateral fold paralysis.
abstract: Vocal fold paralysis (VFP) is the second most common congenital abnormality that affects the larynx. Unilateral cases may be asymptomatic or feature symptoms related to laryngeal incompetence, such as aspiration and dysphonia. Management has traditionally been conservative as a high percentage of these paralyses recover spontaneously. The literature is scant on the acute or chronic management of unilateral vocal fold paralysis related symptoms in children. We present a series of four children (age 21 days, 5 years, 5 years, and 18 years) with unilateral VFP paralysis treated with collagen (Cymmtera) augmentation for control of symptoms related to laryngeal incompetence. Two children (age 21 days and 5 years) were managed in the acute setting. Follow-up has ranged from 4 to 12 months, and all have maintained excellent outcomes. Vocal fold augmentation with collagen is an effective therapeutic option in the management of symptoms related to unilateral VFP and laryngeal incompetence. It decreases the risk of aspiration and improves vocal quality. Collagen augmentation can be used in the acute setting to decrease aspiration, possibly avoiding a tracheotomy or gastrostomy tube placement, or to augment patients with a tracheotomy who are still severely aspirating.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Division of Pediatric Otolaryngology, Medical College of Wisconsin, Milwaukebe, WI 53045, USA. napatel@mcw.edu
authors.forename: Nalin J
authors.initials: NJ
authors.lastname: Patel
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kerschner
authors.forename: Albert L
authors.initials: AL
authors.lastname: Merati
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007830:Larynx / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000628:therapy*
chemical_list: D003094:Collagen