Vocal fold paralysis in preterm infants: prevalence and analysis of risk factors

Jabbour, Jad; Uhing, Michael R.; Robey, Thomas

doi:10.1038/jp.2016.263

Cited by 10 publications

(10 citation statements)

References 25 publications

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“…It has been well established in the literature that a weight of less than 1500 grams at the time of PDA ligation is associated with a greater risk of RLN injury. 2,4,6,[9][10][11][12] Our results also demonstrated that a corrected gestational age of less than 30 weeks at time of surgery was associated with an increased risk of LVFP post-op. This finding is consistent with the work of previous authors who suggested that prematurity was a risk factor for LVFP following PDA-ligation.…”

Section: Discussionsupporting

confidence: 71%

“…In particular, young gestational age and low birth weight are independent risk factors for developing LVFP following PDA ligation. [1][2][3][4][5][6] Depending on the extent of injury, LFVP can be a transient condition, but many patients develop lifelong symptoms and complications. 7,8 In recent history, iatrogenic injuries have surpassed congenital anomalies, such as Arnold-Chiari malformation, as the most common cause of vocal fold paralysis among infants.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term Outcomes of Vocal Fold Paralysis Following Patent Ductus Arteriosus Ligation in Neonates

et al. 2022

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Introduction In patients undergoing patent ductus arteriosus (PDA) ligation there is a significant risk of left vocal fold paralysis (LVFP) particularly in premature neonates who are small for gestational age. The objective of this study is to determine the incidence of LVFP in infants following PDA ligation and report on long‐term outcomes in patients with LVFP. Methods We performed a prospective study of patients undergoing PDA ligation in the newborn intensive care unit (NICU) between April 2004 and May 2014. Following PDA ligation, flexible laryngoscopy was performed to assess vocal fold mobility. Patients were then followed longitudinally to determine long‐term outcomes. Results A total of 163 infants underwent PDA ligation. Thirty‐six patients (22%) developed LVFP following the procedure. Twenty‐five percent of neonates <1500 g experienced LVFP versus 5% of patients >1500 g (p = 0.033). Patients with LVFP were more likely to require a feeding tube (64% vs. 19.6%; p < 0.05) and spent more time in the NICU (135 days vs. 106 days; p < 0.05). Twenty‐four patients received long‐term follow‐up. Six (25%) had complete resolution of LVFP, 10 (42%) were compensated, and 8 (33%) demonstrated persistent LVFP with no improvement. Conclusions The incidence of LVFP after PDA ligation is high especially in extremely low birth weight children. The majority of patients recovered well with time, but further surgical intervention was required in uncompensated cases. Long‐term follow‐up of these patients is needed to ensure improvement. Laryngoscope, 133:1257–1261, 2023

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Long‐term Outcomes of Vocal Fold Paralysis Following Patent Ductus Arteriosus Ligation in Neonates

et al. 2022

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“…In addition to the variability among studies, the lack of demographic information precluded the ability to ensure no differences in baseline characteristics between the cohorts. However, the importance of this limitation is questionable, as factors such as sex and race have not been shown to affect VFI diagnosis or outcomes 6,33 . The lack of follow‐up information in several studies also limited the analysis of resolution rates and especially time to resolution.…”

Section: Discussionmentioning

confidence: 99%

“…However, the importance of this limitation is questionable, as factors such as sex and race have not been shown to affect VFI diagnosis or outcomes. 6,33 The lack of follow-up information in several studies also limited the analysis of resolution rates and especially time to resolution. Finally, while not a limitation, this study was not intended to examine what proportion of traumatic births result in VFI.…”

Section: Discussionmentioning

confidence: 99%

Vocal Fold Immobility due to Birth Trauma: A Systematic Review and Pooled Analysis

Jabbour

North

Bougie

et al. 2017

Otolaryngol.--head neck surg.

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Objectives To describe the present understanding of birth trauma-related vocal fold immobility and quantitatively compare it with idiopathic congenital vocal fold immobility to explore whether it is a discrete entity. Data Sources PubMed, Ovid, and Cochrane databases. Review Methods English-language, observational, or experimental studies involving infants with idiopathic congenital or birth trauma-related vocal fold immobility were included. Data from these studies were pooled with our institution's vocal fold immobility database, with the resultant idiopathic congenital and birth trauma cohorts compared regarding patterns and outcomes of immobility. Results The search returned 288 articles, with 24 meeting inclusion criteria. Of studies reviewing all-cause immobility, 8 of 9 (88.9%) identified birth trauma as an etiology, although birth trauma definitions and proposed mechanisms of immobility varied. The study subjects, combined with our institution's database, yielded 188 idiopathic congenital and 113 birth trauma cases. Compared with idiopathic congenital cases, birth trauma cases had a higher proportion of unilateral immobility (72 of 113 [63.7%] vs 52 of 188 [27.7%], P < .001) and rate of resolution (41 of 51 [80.4%] vs 91 of 159 [57.2%], P = .003). Resolution occurred in 24 of 26 (91.3%) unilateral and 17 of 25 (68.0%) bilateral birth trauma cases and in 30 of 40 (75.0%) unilateral and 59 of 109 (54.1%) bilateral idiopathic congenital cases ( P = .11 and .20, respectively). Conclusion While the definition and mechanism of birth trauma-related vocal fold immobility warrant further investigation, these findings suggest that it is distinct from idiopathic congenital vocal fold immobility, with a unique presentation and potentially more favorable outcomes. This can inform counseling and management for infants with otherwise unexplained immobility but known birth trauma.

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“…Vocal cord paralysis (VCP) is a common airway abnormality in neonates in which one or both of the vocal cords are unable to adduct or abduct properly [ 9 ]. It comprises up to 10% of all congenital laryngeal lesions, second only to laryngomalacia, and has been found in 3.5% of preterm infants in the Neonatal ICU, with incidence increasing to 18% in patients born before 26 weeks GA [ 10 , 11 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Neonatal Airway Abnormalities

Srikanthan

Scott²,

Desai³

et al. 2022

Children

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Neonatal airway abnormalities are commonly encountered by the neonatologist, general pediatrician, maternal fetal medicine specialist, and otolaryngologist. This review article discusses common and rare anomalies that may be encountered, along with discussion of embryology, workup, and treatment. This article aims to provide a broad overview of neonatal airway anomalies to arm those caring for these children with a broad differential diagnosis and basic knowledge of how to manage basic and complex presentations.

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Vocal fold paralysis in preterm infants: prevalence and analysis of risk factors

Abstract: Given the prevalence of VFP and its associated morbidity, efforts to decrease PDA ligation and invasive ventilation in preterm infants are warranted.

Cited by 10 publications

References 25 publications

Long‐term Outcomes of Vocal Fold Paralysis Following Patent Ductus Arteriosus Ligation in Neonates

Long‐term Outcomes of Vocal Fold Paralysis Following Patent Ductus Arteriosus Ligation in Neonates

Vocal Fold Immobility due to Birth Trauma: A Systematic Review and Pooled Analysis

Neonatal Airway Abnormalities

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