Feeding Interventions in Infants with Unilateral Vocal Fold Immobility Following Cardiac Surgery: A Retrospective...

Despite well-established risks of post-operative dysphagia in infants with congenital heart defects (CHD) secondary to unilateral vocal fold immobility (UVFI), there is a lack of standardization to feeding interventions for this high-risk population. Therefore, we sought to retrospectively determine if using thickened liquids compared to a slower flow rate nipple more effectively eliminated aspiration as seen on a videofluoroscopic swallow study (VFSS) in 2 groups of infants with post-operative UFVI, those treated with injection laryngoplasty (IL) and those without IL. A retrospective chart review of VFSSs was conducted on all participants who met inclusion criteria from 2017 to 2022. VFSS results were separated between two groups and effectiveness of feeding interventions performed when aspiration was detected was documented. Data were evaluated using descriptive statistics and differences between groups were assessed with Fisher's Exact Test. A total of 33 VFSSs were included, accounting for 27 study participants. The mean age of participants was 12 weeks (SD = 14.4). After data analyses, it was found that thickened liquids reduced the incidence of aspiration more often than an extra slow flow rate nipple (72% vs 60%; p = 0.68) for the Non-IL group, while an extra slow flow rate nipple decreased incidence of aspiration compared to thickened liquids (92% vs 67%; p = 0.22) for the IL group. While these results did not reach statistical significance, the findings are clinically relevant and may be used to guide feeding interventions in infants with UVFI, to decrease aspiration-related postoperative morbidity.