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Clinical Prognosis of Vocal Cord Paralysis After Cardiothoracic Surgery in Infants

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Abstract

We aimed to clarify the long-term outcomes and prognosis of vocal cord paralysis (VCP) after cardiothoracic surgery in infants as well as the usefulness of laryngeal ultrasound (LUS) as screening for VCP. Overall, 967 infants aged 1-year-old or younger who underwent cardiothoracic surgery between 2008 and 2022 were included in this study. We divided the patients into two groups based on the period on whether they underwent screening without or with LUS and compared the incidence of VCP between the groups. There were no differences in the patients’ preoperative characteristics between the two periods, whereas the incidence of VCP was significantly higher in period 2 than in period 1 (11.0% vs. 3.2%, p < 0.0001). The incidence of VCP among the procedures, including aortic arch repair, was > 50% and significantly increased from period 1 to period 2. The sensitivity and specificity of LUS was 87% and 90%, respectively. Symptoms of VCP improved in 92% of patients. Repeated flexible laryngoscopy revealed that the residual rate of VCP was 68%, 52%, and 48% at 6, 12, and 24 months, respectively. In conclusion, symptoms of postoperative VCP improved in most cases; however, paralysis persisted in half of the patients. As a screening method, LUS is useful for evaluating postoperative VCP. A more accurate understanding of VCP is needed to improve postoperative outcomes.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Miyagi Children’s Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai, 989-3126, Japan

    Naoki Masaki, Hideki Tatewaki, Masaru Kumae, Tomonori Ochiai & Sadahiro Sai

  2. Department of Intensive Care Medicine, Miyagi Children’s Hospital, Sendai, Japan

    Taku Koizumi, Tanomo Ono & Kenji Sonota

  3. Department of Cardiology, Miyagi Children’s Hospital, Sendai, Japan

    Masato Kimura & Akira Ozawa

Authors
  1. Naoki Masaki
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  2. Hideki Tatewaki
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  3. Masaru Kumae
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  4. Tomonori Ochiai
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  5. Taku Koizumi
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  6. Tanomo Ono
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  7. Kenji Sonota
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  8. Masato Kimura
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  9. Akira Ozawa
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  10. Sadahiro Sai
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Contributions

NM drafted and edited the manuscript; TO, MK, KS and TO contributed to data collection and refinement. NM contributed to data refinement and led the statistical analysis. TK, MK, AO and HT significantly edited the manuscript and oversaw the study from design to completion. SS significantly edited the manuscript and supervised the work and submission. All authors agree to be accountable for the content of the work.

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Correspondence to Sadahiro Sai.

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Masaki, N., Tatewaki, H., Kumae, M. et al. Clinical Prognosis of Vocal Cord Paralysis After Cardiothoracic Surgery in Infants. Pediatr Cardiol 45, 40–47 (2024). https://doi.org/10.1007/s00246-023-03341-4

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  • DOI: https://doi.org/10.1007/s00246-023-03341-4

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