Unilateral Vocal Cord Paralysis Following Patent Ductus Arteriosus Ligation in Extremely Low-Birth-Weight Infants

Abstract

There was a high incidence of occurrence of UVCP (67%) associated with PDA ligation in ELBW infants. Unilateral vocal cord paralysis following PDA ligation does seem to be associated with increased requirements for tube feeding, respiratory support, and hospital stay in these ELBW infants.

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

“…Thirty-two studies that satisfied the inclusion criteria were included in the analysis (Fig 1). OCEBM levels of evidence varied from level 3 (9 studies) [9][10][11][14][15][16]20,23,26 to level 4 (23 studies) [6][7][8]12,13,[17][18][19]21,22,24,25,[27][28][29][30][31][32][33][34][35][36][37] ( Table 1). Occurrence of UVFP, type of surgery, patient demographics, and vocal fold assessment are reported in Table 1.…”

“…Among patients undergoing any type of cardiothoracic surgery procedure, 11 studies involving 584 patients postoperatively evaluated every patient with flexible nasopharyngolaryngoscopy. 6,[9][10][11][14][15][16][17]20,22,23 The weighted pooled proportion for UVFP was 29.8% (95% CI, 18.5% to 42.5%) (Fig 4). Heterogeneity analysis measured an I 2 of 90.4% (95% CI, 85.2% to 93.1%).…”

“…7,8,[10][11][12][13][14][15]17,20,21,24,[27][28][29][30][31][34][35][36][37] The weighted pooled proportion was 8.7% (95% CI, 5.4% to 12.6%) (Fig 3). Heterogeneity analysis measured an I 2 of 81.6% (95% CI, 65.0% to 88.4%).…”

“…Six studies involving 274 patients postoperatively evaluated every patient with flexible nasopharyngolaryngoscopy after PDA ligation. 10,11,14,15,17,20 The weighted pooled proportion for UVFP was 39% (95% CI, 18% to 63%) (Fig 5). UVFP after all types of cardiothoracic surgery (32 studies).…”

Learning to live with patency of the ductus arteriosus in preterm infants

“…Ligation may be followed by cardiorespiratory decompensation in the immediate postoperative period. 20 Long-term sequelae include an increased risk of BPD, 9,10,21 retinopathy of prematurity 21 and neurodevelopmental impairment, 21 as well as left vocal cord paralysis, [22][23][24] diaphragmatic paresis 24 or eventration, 25 chylothorax 24,26,27 and scoliosis. 28 Treatment with COX inhibitors may be associated with renal impairment, 29 spontaneous intestinal perforation, 30,31 IVH 2 and changes in cerebrovascular autoregulation 32 (of uncertain significance).…”