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Clinical Prognosis of Vocal Cord Paralysis After Cardiothoracic Surgery in Infants

Naoki Masaki1, Hideki Tatewaki1, Masaru Kumae1

  • 1Department of Cardiovascular Surgery, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai, 989-3126, Japan.

Pediatric Cardiology
|December 9, 2023
PubMed

Insights

Postoperative vocal cord paralysis (VCP) in infants following cardiothoracic surgery is common, though symptoms often improve. Laryngeal ultrasound (LUS) effectively screens for VCP, aiding in better patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Otolaryngology
  • Cardiology

Background:

  • Vocal cord paralysis (VCP) is a potential complication of infant cardiothoracic surgery.
  • Long-term outcomes and effective screening methods for VCP require further clarification.

Purpose of the Study:

  • To evaluate the long-term prognosis of VCP in infants after cardiothoracic surgery.
  • To assess the utility of laryngeal ultrasound (LUS) as a screening tool for VCP.

Main Methods:

  • Retrospective analysis of 967 infants (≤1 year) undergoing cardiothoracic surgery (2008-2022).
  • Comparison of VCP incidence between periods with and without LUS screening.
  • Assessment of LUS sensitivity and specificity.

Main Results:

  • VCP incidence was significantly higher in the LUS screening period (11.0%) compared to the non-LUS period (3.2%).
  • Procedures like aortic arch repair showed >50% VCP incidence, increasing with LUS implementation.
  • LUS demonstrated 87% sensitivity and 90% specificity for VCP screening.

Conclusions:

  • While most VCP symptoms improve, persistent paralysis affects approximately half of infant patients post-surgery.
  • Laryngeal ultrasound is a valuable screening tool for identifying postoperative VCP in infants.
  • Further research is needed to enhance understanding and management of VCP for improved surgical outcomes.

Keywords:
Congenital heart surgeryInfantLaryngeal ultrasoundVocal cord paralysis

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