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Unilateral vocal cord paralysis after surgical closure of a patent ductus arteriosus in extremely preterm infants
Author(s) -
Pharande Pramod,
Karthigeyan Sathiyapriya,
Walker Karen,
D'Cruz Daphne,
Badawi Nadia,
Luig Melissa,
Winlaw David,
Popat Himanshu
Publication year - 2017
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13632
Subject(s) - medicine , ductus arteriosus , interquartile range , vocal cord paralysis , ligation , gestational age , cord , pediatrics , gestation , paralysis , retrospective cohort study , cohort , incidence (geometry) , anesthesia , surgery , pregnancy , physics , biology , optics , genetics
Aim Left vocal cord paralysis ( LVCP ) is variably reported post ligation of patent ductus arteriosus ( PDA ). Our objective was to determine the incidence of LVCP and identify predictive factors and associated morbidities in preterm infants post PDA ligation. Methods This is a retrospective cohort study of infants less than 29 weeks gestational age from 2006 to 2014 who underwent PDA ligation. Infants with laryngeal symptoms underwent flexible fibreoptic nasopharyngolaryngoscopy to evaluate vocal cord function. We compared short‐ and long‐term morbidities among infants with and without symptomatic LVCP . Results A total of 35 infants underwent PDA ligation in the study period, of which 11 infants (31%) developed symptomatic LVCP . Dysphonia was the presenting symptom in all neonates with LVCP and stridor was present in 46% (5/11) of them. The median (interquartile range) gestation (25 weeks (24–27) vs. 25 weeks (23–28)), birthweight (810 g (550–1180) vs. 825 g (550–1220)) and age at surgery (19 days (9–27) vs. 20 (5–69)) were similar in infants with and without LVCP , respectively. Infants with LVCP took significantly longer to reach suck feeds (128 vs. 90 days, P = <0.001), stayed longer in hospital (119 vs. 95 days, P = 0.01) and were more likely to go home on oxygen (73 vs. 27%; P = 0.024). Neurodevelopmental outcomes were similar in the two groups. Conclusions 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.