scholarly journals 391: LARYNGEAL ULTRASOUND EVALUATION OF VOCAL FOLD IMMOBILITY AFTER PEDIATRIC CARDIAC SURGERY

2021 ◽  
Vol 50 (1) ◽  
pp. 183-183
Author(s):  
Ernesto Fernandez ◽  
Vidit Bhargava ◽  
Erika Mendoza ◽  
Michelle Ramirez ◽  
Sarah Ginsburg ◽  
...  
2021 ◽  
Vol 12 (4) ◽  
pp. 535-541
Author(s):  
Jennifer M. Barr ◽  
Kandice Bowman ◽  
Monica Deshpande ◽  
Elizabeth N. Dewey ◽  
Henry A. Milczuk ◽  
...  

Background: Loss of laryngeal function after congenital cardiac surgery causes morbidity and prolongs hospitalization. Early diagnosis of vocal fold immobility (VFI) and referral to pediatric otolaryngology (pOTO) aids in laryngeal rehabilitation. Understanding the incidence and recovery rates of VFI enables counseling for families of infants undergoing high-risk surgery. Methods: A retrospective chart review from November 2014 to July 2019 of infants postcardiac surgery where the aortic arch or surrounding structures were manipulated and were screened via flexible fiberoptic laryngoscopy (FFL) at a single institution was performed. Patients were divided into five surgical categories: Norwood procedure, aortic arch augmentation via median sternotomy, arterial switch operation, coarctation repair via lateral thoracotomy, and cardiac surgeries including ligation of a patent ductus arteriosus (PDA). Patients undergoing isolated PDA ligation were excluded. Results: One hundred ninety-nine qualifying operations occurred during this period; 28 patients did not undergo FFL before discharge and were excluded from the analysis. Immediately following cardiac surgery, 34% (58 of 171 patients) had VFI. Follow-up was completed by 38 of 58 patients with VFI. Complete recovery was demonstrated in 63% (24 of 38) of patients by 6 months and in 86% (33 of 38) within 18 months. The highest risk occurred with the Norwood procedure and arch augmentation via median sternotomy. Conclusions: Infants undergoing surgery involving the aortic arch and surrounding structures have high rates of VFI. Follow-up by pOTO is recommended to optimize laryngeal rehabilitation. Most patients have spontaneous recovery within 18 months of cardiac surgery.


2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
T Miyamoto ◽  
A Inui ◽  
T Yoshii ◽  
M Seki ◽  
K Nakajima ◽  
...  

2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
A Rastan ◽  
T Walther ◽  
A Fabricius ◽  
I Daehnert ◽  
J Hambsch ◽  
...  

2021 ◽  
pp. 1-9
Author(s):  
Aditi Sinha ◽  
Alexander Geragotellis ◽  
Guntaj Kaur Singh ◽  
Devika Verma ◽  
Daniyal Matin Ansari ◽  
...  

Abstract Background: Vocal cord palsy is one of the recognised complications of complex cardiac surgery in the paediatric population. While there is an abundance of literature highlighting the presence of this complication, there is a scarcity of research focusing on the pathophysiology, presentation, diagnosis, and treatment options available for children affected by vocal cord palsy. Materials and methods: Electronic searches were conducted using the search terms: “Vocal Cord Palsy,” “VCP,” “Vocal Cord Injury,” “Paediatric Heart Surgery,” “Congenital Heart Surgery,” “Pediatric Heart Surgery,” “Vocal Fold Movement Impairment,” “VFMI,” “Vocal Fold Palsy,” “PDA Ligation.” The inclusion criteria were any articles discussing the outcomes of vocal cord palsy following paediatric cardiac surgery. Results: The two main populations affected by vocal cord palsy are children undergoing aortic arch surgery or those undergoing PDA ligation. There is paucity of prospective follow-up studies; it is therefore difficult to reliably assess the current approaches and the long-term implications of management options. Conclusion: Vocal cord palsy can be a devastating complication following cardiac surgery, which if left untreated, could potentially result in debilitation of quality of life and in severe circumstances could even lead to death. Currently, there is not enough high-quality evidence in the literature to aid recognition, diagnosis, and management leaving clinicians to extrapolate evidence from adult studies to make clinical judgements. Future research with a focus on the paediatric perspective is necessary in providing evidence for good standards of care.


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