Outcomes of Vocal Fold Immobility After Pediatric Cardiovascular Surgery.
Cardiovascular surgery is increasingly performed in children for congenital malformations of the heart and great vessels. Observed as vocal fold immobility, recurrent laryngeal nerve injury is a well-described complication. As overall outcomes improve and patients live longer, the sequelae of vocal fold immobility amplify insignificance.
Families are often unaware of the long-term issues related to vocal fold immobility especially with regard to need for alternative alimentation routes. We report on the incidence of use of feeding tubes, the timing of vocal fold function return and need for additional aerodigestive interventions.
Counseling of families and primary care providers regarding the impact of pediatric vocal fold immobility after cardiac surgery should include the high potential requirement for supplemental alimentation as well as the need for feeding and speech therapy.
Longitudinal otolaryngology and speech pathology care is imperative with vocal fold immobility since the majority of these patients do not experience functional recovery and may require further interventions over time.
Cardiovascular surgery is increasingly performed in infants to correct congenital malformations of the heart and great vessels. Due to the anatomic course of the recurrent laryngeal nerve, it is especially prone to injury during procedures requiring aortic arch manipulation and/or reconstruction.
These malformations
range in both incidence and complexity. Patent ductus arteriosus
represents up to 10% of all congenital heart disease with an
incidence of up to 2.8 per 1000 live births.
Conversely, hypoplastic left heart syndrome is a single ventricle lesion that occurs
in approximately 0.18 per 1000 live births and requires staged palliation and extensive aortic arch reconstruction under deep hypothermic circulatory arrest or regional cerebral perfusion. Observed post-operatively as vocal fold immobility, recurrent laryngeal nerve injury is a well-described complication of these surgeries.
Otolaryngol Open J. 2019; 5(2): 29-33. doi: 10.17140/OTLOJ-5-157