Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T05:18:41.643Z Has data issue: false hasContentIssue false
  • English
  • Français

Incidence and risk factor of vocal cord paralysis following slide tracheoplasty for congenital tracheal stenosis: a retrospective observational study

Part of: Surgery

Published online by Cambridge University Press:  12 July 2021

Naoki Kaneko Open the ORCID record for Naoki Kaneko [Opens in a new window]  and
Tomomi Hasegawa
Naoki Kaneko
Affiliation:
Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
Tomomi Hasegawa*
Affiliation:
Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
*
Author for correspondence: Dr T. Hasegawa, MD, PhD, Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan. Tel: +81 78 945 7300; Fax: +81 78 302 1023. E-mail: tohasegawa_kch@hp.pref.hyogo.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Slide tracheoplasty for congenital tracheal stenosis (CTS) has been shown to improve post-operative outcomes, but the incidence and risk factors of vocal cord paralysis (VCP) following slide tracheoplasty remain unclear. This study aimed to review our experience of slide tracheoplasty for CTS with a focus on post-operative VCP.

Methods:

Twenty-eight patients, who underwent tracheal reconstruction with or without cardiovascular repair at Kobe Children’s Hospital between June, 2016 and March, 2020 were enrolled in this retrospective observational study. They were divided into two groups based on the presence of a pulmonary artery sling (PA sling). Perioperative variables were compared between the two groups.

Results:

Twenty-one of the 28 patients underwent concomitant repair for associated cardiovascular anomalies, including 15 patients with PA sling. The overall incidence of VCP following slide tracheoplasty was 28.6%. The incidences of VCP were 46.7% in patients with CTS and PA sling, which were 14.3% in CTS patients without cardiovascular anomalies. The only risk factor associated with VCP following slide tracheoplasty was a concomitant repair for PA sling. Post-operatively, the duration of nasogastric tube feeding in patients with VCP was significantly longer than that in patients without VCP.

Conclusions:

The incidence of VCP following slide tracheoplasty for CTS was high, especially in concomitant repair cases for PA sling. Routine screening and evaluation of VCP soon after post-operative extubation is required for its appropriate management.

Keywords

Congenital tracheal stenosispulmonary artery slingslide tracheoplastyvocal cord paralysis
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 579 - 583
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Herrera, P, Caldarone, C, Forte, V, et al. The current state of congenital tracheal stenosis. Pediatr Surg Int 2007; 23: 1033–1044.10.1007/s00383-007-1945-3CrossRefGoogle ScholarPubMed
Butler, CR, Speggiorin, S, Rijnberg, FM, et al. Outcomes of slide tracheoplasty in 101 children: a 17-year single-center experience. J Thorac Cardiovasc Surg 2014; 147: 1783–1790.10.1016/j.jtcvs.2014.02.069CrossRefGoogle ScholarPubMed
Hewitt, RJ, Butler, CR, Maughan, EF, Elliott, JM. Congenital tracheobronchial stenosis. Semin Pediatr Surg 2016; 25: 144–149.CrossRefGoogle ScholarPubMed
Stephens, EH, Eltayeb, O, Mongé, MC, et al. Pediatric tracheal surgery: a 25-year review of slide tracheoplasty and tracheal resection. Ann Thorac Surg 2020; 109: 148–154.CrossRefGoogle ScholarPubMed
Manning, PB, Rutter, MJ, Lisec, A, Gupta, R, Marino, BS. One slide fits all: the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children. J Thorac Cardiovasc Surg 2011; 141: 155–161.CrossRefGoogle ScholarPubMed
Hofferberth, SC, Watters, K, Rahbar, R, Fynn-Thompson, F. Evolution of surgical approaches in the management of congenital tracheal stenosis: single-center experience. World J Pediatr Congenit Heart Surg 2016; 7: 16–24.CrossRefGoogle ScholarPubMed
Yokoi, A, Hasegawa, T, Oshima, Y, et al. Clinical outcomes after tracheoplasty in patients with congenital tracheal stenosis in 1997–2014. J Pediatr Surg 2018; 53: 2140–2144.CrossRefGoogle ScholarPubMed
Lee, MGY, Millar, J, Rose, E, et al. Laryngeal ultrasound detects a high incidence of vocal cord paresis after aortic arch repair in neonates and young children. J Thorac Cardiovasc Surg 2018; 155: 2579–2587.CrossRefGoogle ScholarPubMed
Averin, K, Uzark, K, Beekman, RH, et al. Postoperative assessment of laryngopharyngeal dysfunction in neonates after Norwood operation. Ann Thorac Surg 2012; 94: 1257–1261.CrossRefGoogle ScholarPubMed
Pourmoghadam, KK, DeCampli, WM, Ruzmetov, M, et al. Recurrent laryngeal nerve injury and swallowing dysfunction in neonatal aortic arch repair. Ann Thorac Surg 2017; 104: 1611–1619.CrossRefGoogle ScholarPubMed
Gorantla, SC, Chan, T, Shen, I, Wilkes, J, Bratton, SL. Current epidemiology of vocal cord dysfunction after congenital heart surgery in young infants. Pediatr Crit Care Med 2019; 20: 817–825.CrossRefGoogle ScholarPubMed
Ambrose, SE, Ongkasuwan, J, Dedhia, K, et al. Analysis of vocal fold motion impairment in neonates undergoing congenital heart surgery. JAMA Otolaryngol Head Neck Surg 2018; 144: 406–412.CrossRefGoogle ScholarPubMed
Raut, MS, Maheshwari, A, Joshi, R, et al. Vocal cord paralysis after cardiac surgery and interventions: a review of possible etiologies. J Cardiothorac Vasc Anesth 2016; 30: 1661–1667.10.1053/j.jvca.2016.08.002CrossRefGoogle ScholarPubMed
Richter, AL, Ongkasuwan, J, Ocampo, EC. Long-term follow-up of vocal fold movement impairment and feeding after neonatal cardiac surgery. Int J Pediatr Otorhinolaryngol 2016; 83: 211–214.10.1016/j.ijporl.2016.02.014CrossRefGoogle ScholarPubMed
Tibbetts, KM, Wu, D, Hsu, JV, Burton, WB, Nassar, M, Tan, M. Etiology and long-term functional swallow outcomes in pediatric unilateral vocal fold immobility. Int J Pediatr Otorhinolaryngol 2016; 88: 179–183.10.1016/j.ijporl.2016.07.008CrossRefGoogle ScholarPubMed
Raulston, JEB, Smood, B, Moellinger, A, et al. Aspiration after congenital heart surgery. Pediatr Cardiol 2019; 40: 1296–1303.10.1007/s00246-019-02153-9CrossRefGoogle ScholarPubMed
Amer, K. Anatomy of the thoracic recurrent laryngeal nerves from a surgeon’s perspective. Anat Physiol 2017; 7: 272.Google Scholar
Lawlor, CM, Zendejas, B, Baird, C, Munoz-San Julian, C, Jennings, RW, Choi, SS. Intraoperative recurrent laryngeal nerve monitoring during pediatric cardiac and thoracic surgery: a mini review. Front Pediatr 2020; 8: 587177.10.3389/fped.2020.587177CrossRefGoogle ScholarPubMed
Stewart, AJ, Butler, CR, Muthialu, N, et al. Swallowing outcomes in children after slide tracheoplasty. Int J Pediatr Otorhinolaryngol 2018; 108: 85–90.CrossRefGoogle ScholarPubMed
Harada, A, Shimojima, N, Shimotakahara, A, et al. Surgical indication for congenital tracheal stenosis complicated by pulmonary artery sling. J Thorac Dis 2019; 11: 5474–5479.CrossRefGoogle ScholarPubMed
Binsalamah, ZM, Thomason, A, Ibarra, C, et al. Midterm outcomes of pulmonary artery sling repair with and without tracheoplasty. Cardiol Young 2020; 31: 51–59.Google ScholarPubMed
Sachdeva, R, Hussain, E, Moss, MM, et al. Vocal cord dysfunction and feeding difficulties after pediatric cardiovascular surgery. J Pediatr 2007; 151: 312–315.CrossRefGoogle ScholarPubMed
Dewan, K, Cephus, C, Owczarzak, V, Ocampo, E. Incidence and implication of vocal fold paresis following neonatal cardiac surgery. Laryngoscope 2012; 122: 2781–2785.CrossRefGoogle ScholarPubMed
Hamadah, HK, Kabbani, MS. Bedside ultrasound in the diagnosis and treatment of children with respiratory difficulty following cardiac surgery. J Clin Imaging Sci 2018; 30: 95–101.Google Scholar
Hasegawa, T, Masui, M, Kurosawa, H. Ultrasonographic assessment of vocal cord paralysis in an infant after cardiovascular surgery. J Pediatr Cardiol Card Surg 2018; 2: 101–103.Google Scholar