Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus: vascular clip versus suture ligature

William C Spanos; James T Brookes; Mark C Smith; Harold M Burkhart; Edward F Bell; Richard J H Smith

doi:10.1177/000348940911801011

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Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus: vascular clip versus suture ligature

Journal article

Peer reviewed

Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus: vascular clip versus suture ligature

William C Spanos, James T Brookes, Mark C Smith, Harold M Burkhart, Edward F Bell and Richard J H Smith

Annals of otology, rhinology & laryngology, Vol.118(10), pp.750-753

10/2009

DOI: 10.1177/000348940911801011

PMID: 19894404

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Abstract

We investigated risk factors associated with unilateral iatrogenic vocal fold paralysis (IVFP) in the context of ligation of patent ductus arteriosus (PDA) and compared the rates of paralysis between vascular clip and suture ligation procedures. We performed a prospective examination of infants with isolated PDA treated surgically during 1995 to 2005. Statistical significance was determined with a 2-tailed t-test. Of 68 PDA ligations, 13 cases of left-sided IVFP were diagnosed, for an overall incidence of 19%. All cases of IVFP occurred in 55 infants who weighed less than 1 kg at birth. Suture ligature was used in 60% of all PDA ligation patients, and vascular clips in 40%. The incidence of IVFP in patients with vascular clips (19%) was similar to the incidence in those with suture ligature (20%). Hoarseness or stridor was present in 69% of patients with IVFP, compared to 17% of normal controls (p <0.001). The rate of aspiration was not increased in the IVFP group; however, 15% of the patients with IVFP had episodes of decreased oxygen saturation, versus 7% of infants with normal vocal fold mobility. A hoarse infant with a birth weight of less than 1 kg who has undergone PDA ligation should be examined for unilateral IVFP. Vascular clips and suture ligature are associated with similar rates of IVFP.

Ductus Arteriosus, Patent - surgery

Prospective Studies

Humans

Ligation - instrumentation

Infant, Premature, Diseases - etiology

Vocal Cord Paralysis - diagnosis

Male

Oxygen - metabolism

Laryngoscopy

Vocal Cord Paralysis - metabolism

Infant, Premature

Sutures

Female

Vocal Cord Paralysis - etiology

Iatrogenic Disease

Infant, Newborn

Details

Title: Subtitle: Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus: vascular clip versus suture ligature
Creators: William C Spanos - Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
James T Brookes
Mark C Smith
Harold M Burkhart
Edward F Bell
Richard J H Smith
Resource Type: Journal article
Publication Details: Annals of otology, rhinology & laryngology, Vol.118(10), pp.750-753
DOI: 10.1177/000348940911801011
PMID: 19894404
NLM abbreviation: Ann Otol Rhinol Laryngol
ISSN: 0003-4894
eISSN: 1943-572X
Publisher: United States
Language: English
Date published: 10/2009
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Radiation Oncology; Neonatology; Otolaryngology; Internal Medicine
Record Identifier: 9984007187002771

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