Neonatal vocal fold motion impairment after complex aortic arch reconstruction: What should parents expect after diagnosis?
| Autor: | Harold M. Burkhart, Jess L. Thompson, Jennifer P. Rodney, Michael P. Anderson |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Parents Aortic arch medicine.medical_specialty medicine.medical_treatment Aorta Thoracic Vocal Cords 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors 030225 pediatrics medicine.artery medicine Paralysis Humans Vocal cord paralysis 030223 otorhinolaryngology Retrospective Studies business.industry Incidence Incidence (epidemiology) Infant Newborn General Medicine medicine.disease Dysphagia Gastrostomy Surgery Otorhinolaryngology Median sternotomy Case-Control Studies Pediatrics Perinatology and Child Health Female medicine.symptom business Vascular Surgical Procedures Vocal Cord Paralysis |
| Zdroj: | International Journal of Pediatric Otorhinolaryngology. 120:40-43 |
| ISSN: | 0165-5876 |
| DOI: | 10.1016/j.ijporl.2019.02.006 |
| Popis: | Objectives To study the incidence, sequelae, follow up, and recovery rate of vocal fold motion impairment (VFMI) after complex aortic arch reconstruction in neonates. Study design Retrospective case control study. Methods We retrospectively evaluated 105 neonates who underwent complex aortic arch reconstruction from 2014 to 2016. We compared patients that did have VFMI compared to a control group of patients with normal vocal fold movement. Descriptive statistics were computed for all demographic and clinical variables by treatment group. Results 36% of patients were evaluated for VFMI (n = 38) by an otolaryngologist. The incidence of VFMI was 22% (n = 23). Females were more likely to have VFMI (p = 0.02). Aspiration was more common in patients with VFMI (p = 0.006). The difference in age, weight, incidence of pneumonia, nasogastric tube, gastrostomy, total length of stay, genetic anomaly, and reintubation was not significant between the VFMI group and control group (p > 0.05). Tracheostomy was not performed in any patients with unilateral paralysis. Only 61% of patients followed up in clinic (n = 14). 64% of patients showed improvement or resolution (n = 9). Average time to improvement was 4.8 months. Average time to complete resolution was 10.5 months. Conclusions VFMI after complex aortic arch reconstruction is relatively common. Despite increased aspiration in patients with VFMI, pneumonia did not occur at all in either group. Tracheostomy was not necessary in any patients with a unilateral paralysis. Most patients showed an improvement in the VFMI within 5 months of surgery. Our data support the need for otolaryngology follow-up after the diagnosis of VFMI. |
| Databáze: | OpenAIRE |
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