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Vocal cord dysfunction after pediatric cardiac surgery: A prospective implementation study.

Louise Kenny1,2,3, Amy McIntosh2,3, Karen Jardine4

  • 1School of Clinical Medicine, Children's Health Queensland Clinical Unit, University of Queensland, Brisbane, Queensland, Australia.

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|September 29, 2022
PubMed
Summary
This summary is machine-generated.

Postoperative vocal cord dysfunction (VCD) after pediatric cardiothoracic surgery affects feeding but typically resolves within months. Combined speech pathology assessment and laryngeal ultrasound offer reliable diagnosis.

Keywords:
ENT, ear, nose, throatFDL, flexible direct laryngoscopyLUS, laryngeal ultrasoundNGT, nasogastric tubePICU, pediatric intensive care unitRLN, recurrent laryngeal nerveVCD, vocal cord dysfunctionVCP, vocal cord palsypediatric cardiac surgeryrecurrent laryngeal nervevocal cord dysfunction

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Area of Science:

  • Pediatric Cardiothoracic Surgery
  • Vocal Cord Dysfunction
  • Implementation Science

Background:

  • Postoperative vocal cord dysfunction (VCD) is a potential complication following pediatric cardiothoracic surgery.
  • Understanding its incidence, impact on patient outcomes, and diagnostic methods is crucial for effective management.

Purpose of the Study:

  • To determine the incidence and outcomes of postoperative vocal cord dysfunction (VCD) in children undergoing cardiothoracic surgery.
  • To evaluate diagnostic modalities for VCD in this patient population.

Main Methods:

  • A prospective mixed-methods study incorporating implementation science principles.
  • Patients undergoing aortic arch, ductus, ligamentum arteriosum, or vascular ring surgery were assessed using speech pathology, laryngeal ultrasound, and laryngoscopy.

Main Results:

  • The incidence of VCD ranged from 18% to 56%, with higher rates after hypoplastic aortic arch repair (57%).
  • VCD was associated with increased need for nasogastric feeding but did not significantly impact hospital or ICU stay.
  • Combined speech pathology assessment and laryngeal ultrasound demonstrated 91% sensitivity for VCD diagnosis.

Conclusions:

  • Vocal cord dysfunction (VCD) occurs in about one-third of pediatric cardiothoracic surgery patients, often resolving within three months.
  • Aortic arch repair poses the highest risk for VCD, which can affect feeding.
  • Speech pathology assessment and laryngeal ultrasound provide a reliable and patient-friendly diagnostic approach.