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Pediatric Oncology Patients With Vincristine-Induced Recurrent Laryngeal Nerve Palsy: Two Case Reports and a Brief Review of Literature.
Tay, Sok Yan; Foster, Jennifer; Heczey, Andras; Sitton, Matthew.
Afiliação
  • Tay SY; Department of Pediatric Otolaryngology, Texas Children's Hospital, Houston, TX, USA.
  • Foster J; Texas Children's Hospital, Section of Oncology-Hematology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
  • Heczey A; Texas Children's Hospital, Section of Oncology-Hematology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
  • Sitton M; Department of Pediatric Otolaryngology, Texas Children's Hospital, Houston, TX, USA.
Ear Nose Throat J ; 100(10): NP459-NP463, 2021 Dec.
Article em En | MEDLINE | ID: mdl-32425060
INTRODUCTION: Vincristine (VCR) is a chemotherapeutic agent used widely in the treatment of hematologic and solid tumors, known to result in neurotoxicity, especially with cumulative administrations. Bilateral vocal fold palsy (VFP) is a rare but life-threatening complication of VCR. We report 2 patients with hepatoblastoma presenting with stridor following VCR treatment and propose a management plan. METHODS: Electronic medical records of oncology patients treated at a tertiary hospital with VCR-induced VFP were reviewed. Literature review was performed in PubMed using the terms: hoarseness, VFP, stridor, vincristine. RESULTS: A total of 23 children with VCR-induced VFP were identified from the literature review and adding on our 2 cases. Seventeen (77.3%) were male and 5 (22.7%) were female. The median presenting age was 36.0 months (5-204 months). Acute lymphoblastic leukemia, 15 of 23 (65.2%), was the most common malignancy. Eighteen patients (78.3%) had bilateral VFP and 5 (21.7%) had unilateral VFP. The mean time to VF function recovery was 167.3 days (median: 200.5 days, range: 7-270 days) in the intervention group versus 72.1 days (median: 31.5 days, range: 3-240 days) in the conservative group. One patient in the intervention group had persistent VFP. Sixteen patients (69.6%) were observed, 4 (17.4%) underwent tracheostomy, 1 (4.35%) was intubated, 1 (4.35%) underwent cordectomy, and 1 (4.35%) required positive pressure support. Vincristine was restarted in 12 patients (54.5%), of which 4 developed recurrence of airway symptoms and had to stop VCR. CONCLUSION: A new-onset hoarseness or stridor in a child on VCR should raise the suspicions of VFP. The assumption of an upper respiratory-induced hoarseness or stridor should be avoided. Decisions regarding readministration of VCR and possible airway interventions should be made via a multidisciplinary team approach.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vincristina / Paralisia das Pregas Vocais / Hepatoblastoma / Neoplasias Hepáticas / Antineoplásicos Fitogênicos Limite: Adolescent / Child, preschool / Female / Humans / Infant / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vincristina / Paralisia das Pregas Vocais / Hepatoblastoma / Neoplasias Hepáticas / Antineoplásicos Fitogênicos Limite: Adolescent / Child, preschool / Female / Humans / Infant / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article