Nikki Mills1*, Melissa Keesing2, Ali Mirjalili S3 and David Davies-Payne4
1Department of Otolaryngology, Nelson Marlborough District Health Board, New Zealand
2Department of Pediatric Speech-Language Therapy, Nelson Marlborough District Health Board, New Zealand
3Department of Anatomy and Medical Imaging, University of Auckland, New Zealand
4Department of Pediatric Radiology, Starship Children’s Hospital, New Zealand
Objectives: This manuscript reviews some of the practical difficulties in diagnosing abnormalities of vocal fold motion in neonates, with the potential use of ultrasound to address some of these challenges.
Methods and Results: We present a case report of a 6-week-old infant, referred following cardiac surgery for investigation of stridor exacerbated during breastfeeding. We assessed vocal fold mobility and swallow utilizing using Flexible Endoscopic Evaluation of Swallowing (FEES) and laryngeal ultrasound. Both were performed at bedside during breastfeeding, with Paradoxical Vocal Fold Movement (PVFM) confirmed by both modalities.
Conclusion: This case report illustrates the potential utility of bedside ultrasound in diagnosing Vocal Fold Movement Impairment (VFMI) in infants. Ultrasound is a portable, low risk, noninvasive imaging modality that appears to complement the clinical findings on flexible endoscopy in this cohort, whilst overcoming some of the challenges in diagnosing VFMI in infants.
Ultrasound; Larynx; Vocal fold; Infant; Breastfeeding; FEES; Paradoxical
Mills N, Keesing M, Ali Mirjalili S, Davies-Payne D. The Challenges of Diagnosing Paradoxical Vocal Fold Movement in Infants and the Potential Role for Bedside Ultrasound: A Case Report. Am J Otolaryngol Head Neck Surg. 2022; 5(1): 1170..