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Acute supraglottic laryngitis complicated by vocal fold immobility: prognosis and management

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Acute supraglottic laryngitis (ASL) is manifested by supraglottic inflammation that has the potential for rapid and fatal airway obstruction. Complete/incomplete vocal fold immobility (VFIm) in the setting of ASL may contribute to airway obstruction. The rate of VFIm complicating ASL is not known, and it is not clear whether its occurrence alters the course and the management of ASL, particularly the need to secure the airway (by endotracheal intubation/tracheostomy). This study seeks to describe the natural history of VFIm associated with ASL (ASLIm) and to determine the added effect of VFIm on ASL severity, management, and the need for intervention to secure the airway.

Methods

This is a retrospective cohort study in a tertiary referral center. The medical records of all patients hospitalized due to ASL between January 2007 and December 2016 were reviewed.

Results

Of the 214 patients admitted due to ASL, VFIm was identified in 9 (4.2%). The VFIms resolved within 1–90 days in all 8 patients with available follow-up of 1–3 months. One patient required endotracheal intubation. The 9 ASLIm patients had significantly higher rates of hoarseness and a history of diabetes mellitus. There was no group difference in the need to secure the airway.

Conclusions

VFIm is an apparently uncommon finding among patients with ASL. It appears to be usually transient, short-lasting, and full recovery can be expected. VFIm did not alter the ASL course, nor did it put our patients at increased risk for the need for intervention to secure the airway.

Level of evidence

4.

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Acknowledgements

Esther Eshkol, MA, the institutional medical and scientific copyeditor (Tel-Aviv Sourasky Medical Center) is thanked for editorial assistance. Tomer Ziv, PhD, is thanked for statistical analysis.

Funding

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Authors and Affiliations

  1. The Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizman St., Tel-Aviv, 6423906, Israel

    Barak Ringel, Gilad Horowitz, Shahaf Shilo, Narin N. Carmel Neiderman, Avraham Abergel, Dan M. Fliss & Yael Oestreicher-Kedem

Authors
  1. Barak Ringel
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  2. Gilad Horowitz
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  3. Shahaf Shilo
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  4. Narin N. Carmel Neiderman
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  5. Avraham Abergel
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  6. Dan M. Fliss
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  7. Yael Oestreicher-Kedem
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Corresponding author

Correspondence to Yael Oestreicher-Kedem.

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Ringel, B., Horowitz, G., Shilo, S. et al. Acute supraglottic laryngitis complicated by vocal fold immobility: prognosis and management. Eur Arch Otorhinolaryngol 276, 2507–2512 (2019). https://doi.org/10.1007/s00405-019-05508-3

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  • DOI: https://doi.org/10.1007/s00405-019-05508-3

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