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Uniqueness of laryngeal nerve injury following heart transplantation
Author(s) -
de la Rosa Angelo,
Aguilar Jack,
Barbu Anca M.,
Chang David,
Kobashigawa Jon
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14075
Subject(s) - medicine , heart transplantation , transplantation , otorhinolaryngology , incidence (geometry) , laryngoscopy , vocal cord dysfunction , surgery , vocal cord paralysis , recurrent laryngeal nerve , retrospective cohort study , spinal cord injury , cardiology , spinal cord , intubation , paralysis , physics , thyroid , asthma , optics , psychiatry
Background The incidence of recurrent laryngeal nerve injury (RLNI) after heart transplantation has not been well studied. This can manifest as vocal cord dysfunction causing dysphonia. Previous research is limited to aortic, coronary bypass, and valvular surgery. Identifying RLNI after heart transplantation is important in order to more accurately detail complications associated with this major surgery. Methods This is a retrospective study assessing 972 adult patients who underwent orthotopic heart transplantation between 2010‐2019. Primary outcome was incidence of RLNI. Secondary outcomes were 1‐year mortality and length of stay. Cardiology and otolaryngology notes were examined. Key word searches were used to identify possible RLNI in patients' health care record. Results 2.9% (29/972) of patients developed new RLNI confirmed by laryngoscopy during hospitalization. Patients with RLNI had a significantly increased risk of 1‐year mortality ( P = .015) and length of stay ( P = .006) compared to those without RLNI. 68.9% (20/29) of RLNI was left‐sided (68.9%). Conclusions Recurrent laryngeal nerve injury is a recognizable adverse outcome following heart transplantation. This study supports that RLNI is associated with increased 1‐year mortality and length of stay. Early otolaryngology evaluation may be warranted to evaluate vocal cord mobility and address potential management.