Should all newborns who undergo patent ductus arteriosus ligation be examined for vocal fold mobility?
- 21 July 2009
- journal article
- pediatric airway
- Published by Wiley in The Laryngoscope
- Vol. 119 (8), 1606-1609
- https://doi.org/10.1002/lary.20148
Abstract
Objectives/Hypothesis: To determine the incidence of left vocal fold paralysis (LVFP) in premature infants who undergo patent ductus arteriosus (PDA) ligation. Study Design: Prospective cohort. Methods: The study was carried out in the newborn intensive care unit (NICU) of a tertiary academic medical center. Eighty-six premature newborns who underwent ligation of a PDA were examined postextubation with fiberoptic laryngoscopy to assess vocal fold mobility, regardless of laryngeal symptom status. Results: Fourteen infants (16%) had LVFP. All were <28 weeks postmenstrual age (PMA) at birth and <1,250 g at PDA ligation, and were significantly less mature and smaller than infants without LVFP. Infants <28 weeks PMA at birth and <1,250 g at ligation had an incidence of LVFP of 23% and 24%, respectively. Fourteen percent of the infants with LVFP did not have laryngeal symptoms and would have been missed had these been the sole criteria for assessing vocal fold mobility. Conclusions: The incidence of LVFP after PDA ligation in the NICU is high, and some cases may be missed if laryngoscopy is performed only when laryngeal symptoms are present. Infants <28 weeks PMA at birth and <1,250 g at ligation are at especially high risk. Vocal fold mobility should be documented by laryngoscopy on all high-risk infants undergoing a PDA ligation in the NICU regardless of laryngeal symptom status, and on all infants with relevant symptoms. The high incidence of this complication warrants greater efforts to prospectively assess vocal fold mobility status in high-risk infants who undergo PDA ligation. Laryngoscope, 2009Keywords
This publication has 5 references indexed in Scilit:
- Sequelae of recurrent laryngeal nerve injury after patent ductus arteriosus ligationInternational Journal of Pediatric Otorhinolaryngology, 2006
- Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysisBMC Pediatrics, 2006
- Incidence of vocal fold paralysis in infants undergoing ligation of patent ductus arteriosusThe Annals of Thoracic Surgery, 1996
- Vocal Cord Paralysis in Premature Infants Undergoing Ductal ClosureThe Annals of Thoracic Surgery, 1988
- Surgical and medical experience with 734 premature infants with patent ductus arteriosusThe Journal of Thoracic and Cardiovascular Surgery, 1982