Am J Otolaryngol Head Neck Surg | Volume 4, Issue 3 | Case Series | Open Access

Endoscopic Percutaneous Suture Lateralization with Syringe Needles for Neonatal Bilateral Vocal Cord Paralysis

Xiaoya Zhao1,2, Shang Yan1, Hui Yang3, Lan Li1and Hongguang Pan1*

1Department of Otolaryngology, Shenzhen Children’s Hospital, China
2Zunyi Medical University, China
3Department of Neonatology, Shenzhen Children’s Hospital, China

*Correspondance to: Hongguang Pan 

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Objective: To  explore  the  novel  technique  of  percutaneous  endoscopic  suture  lateralization  for Bilateral Vocal Cord Paralysis (BVCP) in neonates from Shenzhen, China, and to evaluate the safety and efficacy of the operation. 1.2. Methods: In this retrospective case series, we present four neonates with BVCP diagnosed within 3 days after birth from Shenzhen Children’s Hospital. All had stridor, respiratory  distress  and  hypoxemia  requiring  respiratory  support  at  diagnosis.  Endoscopic  vocal fold lateralization was performed under general anesthesia using 3.0 mm endotracheal intubation through  the  improved  technique  of  percutaneous  needle-directed  placement  of  a  4  to  0  Prolene suture, without the use of specialized equipment. A 4 to 0 Prolene wire was led out through two 10 ml syringe needles, the left vocal cord was fully moved and fixed under the skin with endoscopy monitoring.

Results: Overall,  3/4  of  the  patients  showed  clinical  improvement  in  stridor  and  dyspnea  2  to  3 weeks after the operation and avoided a tracheostomy, two of them could breathe and feed normally when  they  were  discharged  from  hospital,  and  one patient  had  a  weak  ability  to  suck  but  could breathe normally. The last patient had to undergo a tracheotomy due to the poor improvement in respiratory distress. None of the babies experienced any complications from this surgery, but case four presented with a series of complications and other problems in postoperative care related to the tracheostomy. At the last follow-up (mean 8 months), complete function of the bilateral vocal cords was acquired in case two (6 months) and partial function of the vocal cords was acquired in case one (13 months), with the other cases still experiencing paralysis.

Conclusion: Endoscopic  percutaneous  suture  lateralization  may  be  a  reversible,  effective  and minimally invasive primary treatment for neonatal BVCP. Most of neonates with BVCP undergoing this procedure avoided a tracheotomy.


Bilateral  vocal  cord  paralysis;  Neonatal;  Endoscopic  percutaneous  suture lateralization


Zhao X, Yan S, Yang H, Li L, Pan H. Endoscopic Percutaneous Suture Lateralization with Syringe Needles for Neonatal BilateralVocal Cord Paralysis. Am J Otolaryngol Head Neck Surg. 2021; 4(3): 1130..

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