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

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)750-753
Number of pages4
JournalAnnals of Otology, Rhinology and Laryngology
Volume118
Issue number10
DOIs
StatePublished - Oct 2009
Externally publishedYes

Fingerprint

Patent Ductus Arteriosus
Vocal Cords
Surgical Instruments
Premature Infants
Paralysis
Sutures
Ligation
Blood Vessels
Incidence
Hoarseness
Respiratory Sounds
Birth Weight
Parturition
Oxygen

Keywords

  • Iatrogenic disease
  • Ligation
  • Patent ductus arteriosus
  • Premature infant

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus : Vascular clip versus suture ligature. / Spanos, William C.; Brookes, James T.; Smith, Mark C.; Burkhart, Harold M.; Bell, Edward F.; Smith, Richard J.H.

In: Annals of Otology, Rhinology and Laryngology, Vol. 118, No. 10, 10.2009, p. 750-753.

Research output: Contribution to journalArticle

Spanos, William C. ; Brookes, James T. ; Smith, Mark C. ; Burkhart, Harold M. ; Bell, Edward F. ; Smith, Richard J.H. / Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus : Vascular clip versus suture ligature. In: Annals of Otology, Rhinology and Laryngology. 2009 ; Vol. 118, No. 10. pp. 750-753.
@article{facc3ba1bdd042c6b2aa14aec1a4a462,
title = "Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus: Vascular clip versus suture ligature",
abstract = "Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.",
keywords = "Iatrogenic disease, Ligation, Patent ductus arteriosus, Premature infant",
author = "Spanos, {William C.} and Brookes, {James T.} and Smith, {Mark C.} and Burkhart, {Harold M.} and Bell, {Edward F.} and Smith, {Richard J.H.}",
year = "2009",
month = "10",
doi = "10.1177/000348940911801011",
language = "English (US)",
volume = "118",
pages = "750--753",
journal = "Annals of Otology, Rhinology and Laryngology",
issn = "0003-4894",
publisher = "Annals Publishing Company",
number = "10",

}

TY - JOUR

T1 - Unilateral vocal fold paralysis in premature infants after ligation of patent ductus arteriosus

T2 - Vascular clip versus suture ligature

AU - Spanos, William C.

AU - Brookes, James T.

AU - Smith, Mark C.

AU - Burkhart, Harold M.

AU - Bell, Edward F.

AU - Smith, Richard J.H.

PY - 2009/10

Y1 - 2009/10

N2 - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

AB - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

KW - Iatrogenic disease

KW - Ligation

KW - Patent ductus arteriosus

KW - Premature infant

UR - http://www.scopus.com/inward/record.url?scp=70350519163&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350519163&partnerID=8YFLogxK

U2 - 10.1177/000348940911801011

DO - 10.1177/000348940911801011

M3 - Article

C2 - 19894404

AN - SCOPUS:70350519163

VL - 118

SP - 750

EP - 753

JO - Annals of Otology, Rhinology and Laryngology

JF - Annals of Otology, Rhinology and Laryngology

SN - 0003-4894

IS - 10

ER -