Unilateral vocal cord paralysis after surgical closure of a patent ductus arteriosus in extremely preterm infants

Pharande, Pramod; Karthigeyan, Sathiyapriya; Walker, Karen; D’Çruz, Daphne; Badawi, Nadia; Luig, Melissa; Winlaw, David S.; Popat, Himanshu

doi:10.1111/jpc.13632

Cited by 12 publications

(4 citation statements)

References 33 publications

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“…There are several options for PDA treatment; however, each method has advantages and disadvantages. There are many problems in the ligation or suture of PDA through posterolateral posterior incision, such as large trauma, slow recovery and scar formation (7). This type of ligation is still suitable for all kinds of PDA, including large PDA and window PDA.…”

Section: Discussionmentioning

confidence: 99%

Application of robot-assisted endoscopic technique in the treatment of patent ductus arteriosus in 106 children

Ying

Wang

Liu

et al. 2022

Preprint

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Objective To evaluate and apply the robot-assisted endoscopic surgical technique for treatment of patent ductus arteriosus (PDA) in children. Methods Clinical data of 106 children with PDA who underwent robot-assisted endoscopic operation were retrospectively analyzed from August, 2020 to March, 2022. Demographic and preoperative data were collected, including the patient’s age, weight, diameter of the ductus arteriosus, operation time, length of postoperative hospital stay, postoperative complications and hospitalization cost. The age ranged from 6 months to 12 years with median age of 2.5 years. And the weight ranged from 6.6 kilograms (kg) to 51.6 kg with median weight of 12.5 kg. Patients who received transcatheter PDA closure were also enrolled during the same period. Clinical features and perioperative data were compared between the two groups. Results All the 106 cases underwent robotically assisted surgery for PDA ligation. No one was converted to thoracotomy. The length of operation time was 15–84 minutes, with an average of 39.4 minutes. There was no obvious bleeding during the operation. The length of postoperative hospital stays were 1–3 days, with an average of 1.1 ± 0.2 days, which was significantly shorter than that of patients underwent transcatheter approach PDA closure (2.2 ± 0.2 days) (p < 0.05). The average hospitalization costs were US$ 8180 in the 106 patients, which were more expensive than that of ones who received transcatheter procedure (US$ 5076 ± 406) (p < 0.05). Only one case was found to have residual ductus shunt during early postoperative follow-up. One case was found with recurrent laryngeal nerve injury. All the two cases were recovery after 3 months of follow-up. The median duration of follow-up were 12 (1–20) months. No other short-term complications occurred during the follow-up period. Conclusion Robotic surgical technique for PDA ligation in children is a safe, effective and reliable surgical method with less trauma, faster recovery and fewer surgical risks. This approach should be considered as an option in children patients requiring PDA ligation.

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Section: Discussionmentioning

confidence: 99%

Application of robot-assisted endoscopic technique in the treatment of patent ductus arteriosus in 106 children

Ying

Wang

Liu

et al. 2022

Preprint

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“…This association is thought to be due to the proximity of the left recurrent laryngeal nerve to the PDA 18,19 . VCP has been associated with the occurrence of BPD, gastrostomy tube insertion, and increased duration of mechanical ventilation 9,20–22 . The incidence of VCP following PDA ligation varies widely, ranging from >1% to 64%, 23,24 in part due to differences in the populations studied; premature infants and low birth weight infants are more likely to develop VCP after surgical ligation when compared to term infants 22 .…”

Section: Introductionmentioning

confidence: 99%

Trends in patent ductus arteriosus ligation in neonates and changes in outcomes: A 10‐year multicenter experience

Wang

Jain

Weisz

et al. 2021

Pediatric Pulmonology

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Rationale The management of neonates with patent ductus arteriosus (PDA) has changed over time. Methods We conducted a single‐city, retrospective review of neonates who underwent PDA ligation over a 10‐year time period and compared infants from the first 5 years to the second 5 years to evaluate how clinical characteristics changed over this time. Results Infants from the second 5‐year epoch were older at time of ligation (38 vs. 30 days), had a higher ligation weight (1432 vs. 1121 g) and a lower incidence of postligation cardiac syndrome (1.9% vs. 11.5%). No differences in mortality, length of hospital‐stay or major morbidities were seen. Compared to neonates who underwent PDA ligation at ≤28 days of life, those with a ligation age >28 days had a higher ligation weight (1421 vs. 1039 g), a higher proportion of COX inhibitor use (92.5% vs. 83.8%), and a higher incidence of moderate‐severe bronchopulmonary dysplasia (BPD) (60.4% vs. 44.4%). Only 10.7% (25/233) patients were evaluated by laryngoscopy, in which the incidence of vocal cord paralysis (VCP) was 36.0%; 2 patients were clinically diagnosed with VCP for a total 4.7% incidence of VCP (11/233). Conclusions Over the 10 years examined, neonates underwent PDA ligation at an older age in the second 5‐year time period; this change was not associated with a change in the incidence of major morbidities. Ligation age >28 days was associated with an increase incidence of moderate‐severe BPD. The overall incidence of documented VCP post‐PDA ligation was relatively low but was seen in over 1/3 who were evaluated by laryngoscopy.

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“…reactive airway disease, bronchiectasis, bronchopulmonary dysplasia, recurrent hospital admissions, and need for alternative means of nutrition. 4,[9][10][11][12][13][14] Subjective feeding history correlates poorly with objective aspiration, especially with silent aspiration. 15,16 Objective studies, such as fiberoptic evaluation of swallow or modified barium swallow (MBS), are generally preferred, with comparable sensitivity, specificity, and positive and negative predictive values in identifying premature spillage, penetration, aspiration, residue, and physiologic impairment independent of aspiration events.…”

mentioning

confidence: 99%

“…Glottic incompetence in children has been associated with feeding difficulties, poor weight gain, chronic aspiration, reactive airway disease, bronchiectasis, bronchopulmonary dysplasia, recurrent hospital admissions, and need for alternative means of nutrition 4,9–14 . Subjective feeding history correlates poorly with objective aspiration, especially with silent aspiration 15,16 .…”

mentioning

confidence: 99%

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children: A Systematic Review

Marvin¹,

Coulter²,

Johnson

et al. 2022

Otolaryngol.--head neck surg.

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Objective To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility in children. Data Sources Ovid Medline, Embase, Web of Science, and CENTRAL databases. Review Methods A systematic review of the medical literature was performed following the PRISMA guidelines. An a priori protocol was defined to identify all articles that presented quantifiable outcome data in children aged <18 years who underwent surgical treatment to improve glottal competence for dysphagia. Two authors independently determined references meeting the inclusion criteria, extracted data, and assigned levels of evidence. Data were pooled via a random effects model where possible. The quality of studies was graded with the MINORS criteria. Results An overall 398 publications were screened, with 9 meeting inclusion criteria. A total of 115 patients were included. Of these, 75% had preoperative swallowing symptoms. Surgical intervention for dysphagia included 61 injection laryngoplasties, 11 medialization laryngoplasties, and 10 reinnervations (ansa cervicalis to recurrent laryngeal nerve). The articles consistently reported success in improving dysphagia symptoms, and limited meta-analysis demonstrated a mean improvement after surgical intervention in 79% (95% CI, 67%-91%) of children. The reported rate of minor and major complications was 15% (95% CI, 1%-29%). The MINORS scores ranged from 5 to 12. Conclusion Surgical management of unilateral vocal fold immobility in properly selected children can be an effective treatment for dysphagia when symptoms are present. Selection of surgical modalities relies on patient- and surgeon-related factors, and the rate of success is high across different interventions in treating these complex children.

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Unilateral vocal cord paralysis after surgical closure of a patent ductus arteriosus in extremely preterm infants

Abstract: LVCP was noted in 31% of infants post PDA ligation and was associated with prolonged hospital stay, a longer time to reach suck feeds and a need for home oxygen. No predictive factors for development of LVCP were identified.

Cited by 12 publications

References 33 publications

Application of robot-assisted endoscopic technique in the treatment of patent ductus arteriosus in 106 children

Application of robot-assisted endoscopic technique in the treatment of patent ductus arteriosus in 106 children

Trends in patent ductus arteriosus ligation in neonates and changes in outcomes: A 10‐year multicenter experience

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children: A Systematic Review

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