LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 104 ❚ 1. Recognize that the natural history of laryngomalacia includes resolution of symptoms without therapy in early childhood b. Prognosis with therapy f. Vocal cord paralysis 1. Epidemiology 2. Etiology/Genetics a. Recognize the association between vocal cord paralysis and Arnold-Chiari malformation b. Know the most common etiology of bilateral vocal cord paralysis in a neonate 3. Pathophysiology a. Pathology b. Path mechanisms and consequences 1. Know that vocal cord paralysis can result from local trauma 2. Know that left-sided vocal cord paresis/paralysis can result from trauma to the recurrent laryngeal nerve during birth 3. Know that left-sided vocal cord paresis/paralysis may occur as a complication of cardiac surgery (eg, ligation of a patent ductus arteriosus) 4. Recognize that enlargement of the pulmonary arteries can cause entrapment of the left recurrent laryngeal nerve leading to left vocal cord paralysis 4. Diagnosis and clinical manifestations a. History 1. Know that hoarse voice and mild stridor are associated with unilateral vocal cord paralysis 2. Know that bilateral vocal cord paralysis is rarely associated with abnormal vocalization 3. Recognize that bilateral vocal cord paralysis is associated with increased risk of recurrent aspiration 4. Recognize the clinical presentation of vocal cord paralysis b. Physical examination 1. Recognize that signs of birth trauma indicate the possibility of vocal cord paralysis 2. Recognize that vocal cord paralysis may be an early sign of brain stem or spinal cord compression c. Imaging 1. Recognize the role of magnetic resonance imaging (MRI) of the upper spinal cord and brain stem in evaluating patients with unexplained bilateral vocal cord paralysis d. Other investigations 1. Recognize the findings associated with unilateral or bilateral vocal cord paralysis on fiberoptic laryngoscopy e. Diagnostic criteria f. Complications 5. Prevention and therapeutic approach