Parálisis de cuerda vocal izquierda como complicación de la cirugía del ductus arterioso persistente / Left vocal cord paralysis after patent ductus arteriosus surgery

INTRODUCCIÓN: El ductus arterioso persistente (DAP) es frecuente en prematuros. Su cierre quirúrgico puede causar parálisis de cuerda vocal izquierda (PCVI) por lesión del recurrente. MATERIAL Y MÉTODOS: Estudio retrospectivo de prematuros con DAP de nuestro centro entre 1999-2013. Revisamos sus características y complicaciones de tratamiento. En los pacientes intervenidos se realizó una encuesta sobre síntomas relacionados con PCVI y se ofertó realizar una laringoscopia. RESULTADOS: Revisamos 88 pacientes diagnosticados de DAP en el período de estudio. Doce (13,64%) precisaron cirugía, los de menor edad gestacional y peso al nacer, teniendo mayor necesidad de ventilación mecánica e incidencia de parálisis diafragmática, displasia broncopulmonar y hemorragia intraventricular. El 33,3% (3/9) de los pacientes intervenidos tuvieron PCVI, presentando disfonía todos ellos (100 vs 16,7%, p = 0,05). DISCUSIÓN: La PCVI es una complicación frecuente de la cirugía del DAP. Serían necesarios más estudios que aclaren sus factores de riesgo y consecuencias a corto y largo plazo

INTRODUCTION: Patent ductus arteriosus (PDA) is a common problem in preterm newborns. Left vocal cord paralysis (LVCP) can complicate surgical closure if the recurrent nerve is damaged. MATERIALS AND METHODS: A retrospective case series study was conducted on preterm babies diagnosed with PDA in our unit from 1999 to 2013. Their clinical features and treatment complications were reviewed. In those patients that received surgical treatment a telephone uestionnaire on the symptoms of LVCP symptoms was completed, and laryncoscopy examination offered. RESULTS: A total of 88 subjects diagnosed with PDA were found, of whom 13.64% (12/88) needed surgery. These patients had a lower gestational age and birth weight. They required mechanical ventilation more frequently, and they had more complications such as, diaphragmatic paralysis, bronchopulmonary dysplasia and intraventricular hemorrhage. One third (3/9) of the surgically treated patients had LVCP, and all of them had dysphonia (100% vs. 16.7%, p = .05). DISCUSSION: LVCP is a common complication of PDA surgery. Further studies are needed to determine its risk factors and its short and long-term consequences

[Left vocal cord paralysis after patent ductus arteriosus surgery]. / Parálisis de cuerda vocal izquierda como complicación de la cirugía del ductus arterioso persistente.

INTRODUCTION: Patent ductus arteriosus (PDA) is a common problem in preterm newborns. Left vocal cord paralysis (LVCP) can complicate surgical closure if the recurrent nerve is damaged. MATERIALS AND METHODS: A retrospective case series study was conducted on preterm babies diagnosed with PDA in our unit from 1999 to 2013. Their clinical features and treatment complications were reviewed. In those patients that received surgical treatment a telephone questionnaire on the symptoms of LVCP symptoms was completed, and laryncoscopy examination offered. RESULTS: A total of 88 subjects diagnosed with PDA were found, of whom 13.64% (12/88) needed surgery. These patients had a lower gestational age and birth weight. They required mechanical ventilation more frequently, and they had more complications such as, diaphragmatic paralysis, bronchopulmonary dysplasia and intraventricular hemorrhage. One third (3/9) of the surgically treated patients had LVCP, and all of them had dysphonia (100% vs. 16.7%, p=.05). DISCUSSION: LVCP is a common complication of PDA surgery. Further studies are needed to determine its risk factors and its short and long-term consequences.