Recovery of Vocal Fold Paralysis After Cardiovascular Surgery

Objectives/Hypothesis: To review the incidence and time course of recovery of vocal fold paralysis (VFP) in adult patients after cardiovascular surgery. Study Design: Retrospective cohort study of adults after cardiovascular surgery at a tertiary care academic medical center. Methods: Patients with VFP after cardiovascular surgery were identified from a database of hospitalized patients undergoing voice and swallow evaluation. VFP was confirmed using transnasal fiberoptic laryngoscopy within 1 week of surgery. Follow-up laryngoscopy was performed in those with VFP in the outpatient clinic. Those with persistent paralysis were followed and the time course of recovery was noted. Results: Eighty-six adult postoperative cardiovascular surgery patients (ages 34 to 83 years, mean 68) were identified from the inpatient voice and swallowing evaluation database. There were 20 patients (23%) with unilateral VFP. Thirteen patients followed-up for outpatient laryngoscopy. Ten of the thirteen patients (77%) ultimately had complete resolution of VFP. Three patients had persistent paralysis at a mean follow-up of 18 months. There was no obvious correlation between type of cardiovascular surgery and VFP. Signs of recovery were generally evident prior to 6 months and no recovery was seen beyond 12 months. Conclusions: Most patients with VFP after cardiovascular surgery recover fully. In accordance with previous laryngeal electromyography findings, neuropraxia during cardiovascular surgery will usually recover within 6 months.