Left Vocal Cord Paralysis After Extreme Preterm Birth, a New Clinical Scenario in Adults

Abstract

LVCP is not uncommon in young adults exposed to PDA surgery as preterm infants. The condition may be overlooked easily, and symptoms may be confused with those of other diseases. Laryngoscopy should be offered on the basis of liberal indications after PDA ligation.

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.…”

“…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%).…”

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

“…Totally 50 reported were collected, including 19 (38%) case reports or case series [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], 1 (2%) technique [30], 17 (34%) retrospective [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and 13 (26%) prospective reports [7,11,[49][50][51][52][53][54][55][56][57][58][59].…”

“…The intraoperative damage to the left recurrent laryngeal nerve along its course around the PDA during the dissection of the nerve might result in stretch injury [55]. Røksund et al [11] found that infants with left vocal cord paralysis had a lower birth weight, longer duration of ventilation, and the greater proportion with bronchopulmonary dysplasia. Smith et al [58] noted that infants < 30 weeks postmenstrual age and/or body weight < 1,250 g at PDA ligation were at the highest risk, with an incidence of left vocal cord paralysis of 25%.…”

“…A paramedian position of the left vocal cord may narrow the laryngeal entrance, while collapse of left supraglottic structures may cause airway obstruction. Left vocal cord paralysis may be associated with prolonged inspirium, wheezy respiration, or severe stridor during heavy exercise [11].…”