Our Summary

This research paper is about a rare condition in children called vincristine-induced vocal cord paresis or paralysis (VIVCPP), which is caused by a chemotherapy drug called vincristine. The researchers studied three new cases and found that the symptoms can come and go, can start a long time after the drug is used, and can last for many years after the drug is stopped. One child had symptoms in one vocal cord and the other two had symptoms in both vocal cords. The researchers suggest that doctors need to check for this condition in children who have been given vincristine, by looking at the vocal cords with a special instrument called a laryngoscope. More research is needed to find out how to protect the nerves from damage caused by vincristine and how much vincristine can be given safely to children with cancer.

FAQs

  1. What is vincristine-induced vocal cord paresis or paralysis (VIVCPP)?
  2. How can doctors check for VIVCPP in children who have been given vincristine?
  3. What further research is needed in relation to vincristine and its potential side effects?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vocal cord surgery is to follow all post-operative care instructions carefully, including resting the voice, avoiding strenuous activities, staying hydrated, and attending follow-up appointments with the surgeon. It is also important to communicate any concerns or changes in symptoms to the doctor promptly to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended vocal cord surgery include those with:

  1. Vocal cord paralysis or paresis: This condition can be caused by various factors such as trauma, neurological disorders, or as in the case mentioned above, vincristine-induced vocal cord paresis. Surgery may be recommended to improve voice quality and swallowing function.

  2. Vocal cord nodules or polyps: These benign growths on the vocal cords can cause hoarseness, voice changes, and difficulty speaking. Surgery may be necessary to remove the nodules or polyps and improve vocal function.

  3. Vocal cord cancer: Surgery is often a part of the treatment plan for patients with vocal cord cancer, especially in early stages. The goal of surgery is to remove the cancerous tissue while preserving as much of the vocal cord function as possible.

  4. Vocal cord cysts: These fluid-filled sacs on the vocal cords can cause voice changes and difficulty speaking. Surgery may be recommended to remove the cyst and restore vocal function.

  5. Vocal cord trauma: In cases of severe vocal cord trauma, such as a laceration or injury from intubation, surgery may be necessary to repair the damaged vocal cords and restore voice function.

Overall, the decision to recommend vocal cord surgery is based on the specific condition of the patient and the potential benefits of surgical intervention in improving vocal function and quality of life. It is important for patients to consult with a laryngologist or otolaryngologist (ENT) specialist to discuss the treatment options and determine the most appropriate course of action.

Timeline

Before vocal cord surgery:

  1. Patient is diagnosed with a condition affecting their vocal cords, such as vocal cord paralysis or a vocal cord lesion.
  2. Patient undergoes various tests and evaluations to determine the best course of treatment, including vocal cord functioning tests and imaging studies.
  3. Patient may undergo voice therapy or other non-surgical treatments to improve vocal cord function.
  4. If non-surgical treatments are not effective, patient may be recommended for vocal cord surgery.

After vocal cord surgery:

  1. Patient undergoes vocal cord surgery, which may involve procedures such as vocal cord injection, vocal cord medialization, or vocal cord polyp removal.
  2. Patient experiences a period of recovery, which may include voice rest, speech therapy, and follow-up appointments with the surgeon.
  3. Patient gradually begins to regain vocal cord function and may notice improvements in voice quality and vocal cord movement.
  4. Patient continues to follow up with their healthcare provider to monitor for any complications or recurrence of symptoms.
  5. Patient may continue with voice therapy to further improve vocal cord function and voice quality.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vocal cord surgery?

  2. What is the success rate of the surgery for treating my specific condition?

  3. What is the recovery process like after vocal cord surgery?

  4. Are there any alternative treatments or therapies available for my condition?

  5. How long will it take for me to regain full use of my voice after surgery?

  6. Are there any lifestyle changes or precautions I should take after vocal cord surgery?

  7. Will I need speech therapy or other forms of rehabilitation after the surgery?

  8. What is the long-term prognosis for my voice and overall vocal health after surgery?

  9. Are there any specific factors that could affect the outcome of the surgery in my case?

  10. Are there any additional tests or consultations that I should consider before proceeding with vocal cord surgery?

Reference

Authors: Zavala H, Roby BB, Day A, Bostrom B, Sidman J, Chinnadurai S. Journal: Int J Pediatr Otorhinolaryngol. 2019 Aug;123:1-4. doi: 10.1016/j.ijporl.2019.04.001. Epub 2019 Apr 3. PMID: 31048222