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Int J Pediatr Otorhinolaryngol. 2019 May;120:40-43. doi: 10.1016/j.ijporl.2019.02.006. Epub 2019 Feb 5.

Neonatal vocal fold motion impairment after complex aortic arch reconstruction: What should parents expect after diagnosis?

Author information

1
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States. Electronic address: jenrodney@gmail.com.
2
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States.
3
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States; College of Public Health, Biostatistics and Epidemiology, United States.

Abstract

OBJECTIVES:

To study the incidence, sequelae, follow up, and recovery rate of vocal fold motion impairment (VFMI) after complex aortic arch reconstruction in neonates.

STUDY DESIGN:

Retrospective case control study.

METHODS:

We retrospectively evaluated 105 neonates who underwent complex aortic arch reconstruction from 2014 to 2016. We compared patients that did have VFMI compared to a control group of patients with normal vocal fold movement. Descriptive statistics were computed for all demographic and clinical variables by treatment group.

RESULTS:

36% of patients were evaluated for VFMI (n = 38) by an otolaryngologist. The incidence of VFMI was 22% (n = 23). Females were more likely to have VFMI (p = 0.02). Aspiration was more common in patients with VFMI (p = 0.006). The difference in age, weight, incidence of pneumonia, nasogastric tube, gastrostomy, total length of stay, genetic anomaly, and reintubation was not significant between the VFMI group and control group (p > 0.05). Tracheostomy was not performed in any patients with unilateral paralysis. Only 61% of patients followed up in clinic (n = 14). 64% of patients showed improvement or resolution (n = 9). Average time to improvement was 4.8 months. Average time to complete resolution was 10.5 months.

CONCLUSIONS:

VFMI after complex aortic arch reconstruction is relatively common. Despite increased aspiration in patients with VFMI, pneumonia did not occur at all in either group. Tracheostomy was not necessary in any patients with a unilateral paralysis. Most patients showed an improvement in the VFMI within 5 months of surgery. Our data support the need for otolaryngology follow-up after the diagnosis of VFMI.

KEYWORDS:

Aortic arch reconstruction; Dysphagia; Hoarseness; Median sternotomy; Neonatal cardiac surgery; Neonatal vocal cord paralysis; Pediatric vocal cord paralysis; Vocal cord paralysis; Vocal fold motion impairment; Vocal fold paralysis; Vocal fold paresis

PMID:
30753981
DOI:
10.1016/j.ijporl.2019.02.006
[Indexed for MEDLINE]

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