Laryngotracheal Consequences of Pediatric Cardiac Surgery

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%).…”

Hoarseness subsequent to cardiovascular surgery, intervention, maneuver and endotracheal intubation: The so-called iatrogenic Ortner’s (cardiovocal) syndrome

“…The presentation of unilateral vocal cord paralysis is often a weak cry or low voice after extubation [67]. The diagnosis is best made by fiberoptic laryngoscopy, or barium swallow is best means of diagnosis of pharyngeal function [67].…”

“…The diagnosis is best made by fiberoptic laryngoscopy, or barium swallow is best means of diagnosis of pharyngeal function [67]. Twenty-five (45%) of 55 patients demonstrated aspiration or laryngeal penetration with modified barium swallow [43].…”

Prevalence and Risk Factors for Upper Airway Obstruction after Pediatric Cardiac Surgery

“…Extrathoracic upper airway obstruction is one such complication for which patients undergoing cardiac surgery are particularly at risk, resulting from either pre-existing underlying anatomic abnormalities, operative injury to the recurrent laryngeal nerve, or alterations to the airway associated with postoperative endotracheal intubation. [1][2][3][4][5] Upper airway obstruction can lead to increased work of breathing, derangements in gas exchange, and increased transmural ventricular wall stress, all of which are poorly tolerated by a recovering myocardium. Upper airway obstruction has also been implicated as important contributor to extubation failure, which has been associated with increased morbidity and mortality in this patient population.…”