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Vocal cord paralysis after surgery for thoracic aortic aneurysm
Shin-Ichi Ishimoto1, Ken Ito, Masaaki Toyama
1Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo.
Chest
|June 18, 2002
Summary
Vocal cord paralysis (VCP) is a significant risk after thoracic aortic aneurysm (TAA) surgery, occurring in 32% of patients. This paralysis often persists long-term, even when the recurrent laryngeal nerve is preserved.
Area of Science:
- Cardiovascular Surgery
- Otolaryngology
- Thoracic Surgery
Background:
- Surgery for thoracic aortic aneurysms (TAA) can lead to complications affecting the recurrent laryngeal nerve.
- Vocal cord paralysis (VCP) is a potential sequela of TAA repair, impacting voice quality and respiratory function.
Purpose of the Study:
- To investigate the incidence, causes, prognosis, and treatment strategies for vocal cord paralysis (VCP) following thoracic aortic aneurysm (TAA) surgery.
- To assess the long-term outcomes of VCP in TAA patients.
Main Methods:
- Retrospective analysis of 71 patients undergoing TAA surgery between 1989 and 1995 at a tertiary care center.
- Postoperative voice quality assessment in 62 patients, including laryngoscopy for VCP confirmation.
Main Results:
- Vocal cord paralysis (VCP) was diagnosed in 20 out of 71 patients (32%), with unilateral left VCP in 19 patients.
- The incidence of VCP was notably higher in patients with Type I aneurysms (64%).
- Vocal cord function did not spontaneously recover in 84% of patients followed for over 6 months; surgical interventions like arytenoid adduction and intracordal injection showed success.
Conclusions:
- Thoracic aortic aneurysm (TAA) surgery is associated with a substantial risk of vocal cord paralysis (VCP).
- VCP can occur even with recurrent laryngeal nerve preservation and often lacks spontaneous recovery within 6 months.
- Surgical treatment can improve voice quality in persistent VCP cases post-TAA repair.