Recovery of vocal fold immobility following isolated patent ductus arteriosus ligation

Objective: Identify laryngoscopic and functional outcomes of infants with vocal fold immobility (VFI) following patent ductus arteriosus (PDA) ligation and identify predictors of recovery. Methods: Retrospective review of patients with VFI following PDA ligation from 2001 to 2012 at a single institution. Inclusion criteria were: (1) PDA ligation as only cardiac surgical procedure; (2) left VFI documented by laryngoscopy; (3) minimum follow up 120 days, with at least 2 laryngoscopies performed. Resolution of VFI was determined at follow-up laryngoscopy. Univariate logistic regression models were used to identify variables associated with VFI recovery. Results: 66 subjects were included with median follow up of 3.0 (+/- 2.1) years. The mean gestational age was 24.5 +/- 1.4 weeks, mean birth weight 673 +/- 167 g, and mean age at procedure was 18.6 +/- 143 days. Patients presented with respiratory symptoms (39%), dysphonia (78%) and dysphagia (55%). Resolution of WI was observed in 2/66(3%) patients. Recovery was documented at 20 days and 11 months respectively. Respiratory symptoms, dysphagia, and dysphonia persisted at last follow up in 11%, 47%, and 20% of patients. Conclusions: VFI associated with ligation of the ductus arteriosus has a low rate of recovery. Clinical symptoms frequently persist, and as such regular follow-up by otolaryngologists to mitigate morbidity is indicated. (C) 2014 Elsevier Ireland Ltd. All rights reserved.