Merete Salveson Engeseth1, Nina Rydland Olsen2, Silje Maeland3, Thomas Halvorsen4, Adam Goode5, Ola Drange Røksund6. 1. The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Department of Clinical Science, Section for Paediatrics, University of Bergen, Norway. 2. The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway. 3. The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Uni Research Health, Uni Research, Bergen, Norway. 4. Department of Paediatrics, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Section for Paediatrics, University of Bergen, Norway. 5. Department of Orthopaedic Surgery, Duke University, Durham, NC, USA. 6. The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway. Electronic address: odro@hvl.no.
Abstract
CONTEXT: Extremely premature (EP) infants are at increased risk of left vocal cord paralysis (LVCP) following surgery for patent ductus arteriosus (PDA). OBJECTIVE: A Systematical Review was conducted to investigate the incidence and outcomes of LVCP after PDA ligation in EP born infants. DATA SOURCES: Searches were performed in Cochrane, Medline, Embase, Cinahl and PsycInfo. STUDY SELECTION: Studies describing EP infants undergoing PDA surgery and reporting incidence of LVCP were included. DATA EXTRACTION AND SYNTHESIS: Study details, demographics, incidence of LVCP, diagnostic method and reported outcomes were extracted. DerSimonian and Laird random effect models with inverse variance weighting were used for all analyses. STUDY APPRAISAL: The Newcastle-Ottawa scale for observational studies was used for quality assessment. RESULTS: 21 publications including 2067 infants were studied. The overall pooled summary estimate of LVCP incidence was 9.0% (95% CI 5.0, 15.0). However, the pooled incidence increased to 32% when only infants examined with laryngoscopy were included. The overall risk ratio for negative outcomes was higher in the LVCP group (2.20, 95% CI 1.69, 2.88, p = 0.01) compared to the non-LVCP-group. CONCLUSIONS: Reported incidence of LVCP varies widely. This may be explained by differences in study designs and lack of routine vocal cords postoperative assessment. LVCP is associated with negative outcomes in EP infants. The understanding of long-term outcomes is scarce. Routine laryngoscopy may be necessary to identify all cases of LVCP, and to provide correct handling for infants with LVCP.
CONTEXT: Extremely premature (EP) infants are at increased risk of left vocal cord paralysis (LVCP) following surgery for patent ductus arteriosus (PDA). OBJECTIVE: A Systematical Review was conducted to investigate the incidence and outcomes of LVCP after PDA ligation in EP born infants. DATA SOURCES: Searches were performed in Cochrane, Medline, Embase, Cinahl and PsycInfo. STUDY SELECTION: Studies describing EP infants undergoing PDA surgery and reporting incidence of LVCP were included. DATA EXTRACTION AND SYNTHESIS: Study details, demographics, incidence of LVCP, diagnostic method and reported outcomes were extracted. DerSimonian and Laird random effect models with inverse variance weighting were used for all analyses. STUDY APPRAISAL: The Newcastle-Ottawa scale for observational studies was used for quality assessment. RESULTS: 21 publications including 2067 infants were studied. The overall pooled summary estimate of LVCP incidence was 9.0% (95% CI 5.0, 15.0). However, the pooled incidence increased to 32% when only infants examined with laryngoscopy were included. The overall risk ratio for negative outcomes was higher in the LVCP group (2.20, 95% CI 1.69, 2.88, p = 0.01) compared to the non-LVCP-group. CONCLUSIONS: Reported incidence of LVCP varies widely. This may be explained by differences in study designs and lack of routine vocal cords postoperative assessment. LVCP is associated with negative outcomes in EP infants. The understanding of long-term outcomes is scarce. Routine laryngoscopy may be necessary to identify all cases of LVCP, and to provide correct handling for infants with LVCP.
Authors: Merete S Engeseth; Mette Engan; Hege Clemm; Maria Vollsæter; Roy M Nilsen; Trond Markestad; Thomas Halvorsen; Ola D Røksund Journal: Front Pediatr Date: 2020-04-08 Impact factor: 3.418
Authors: Stephen R Chorney; Karen B Zur; Adva Buzi; Margo K McKenna Benoit; Sri K Chennupati; Stacey Kleinman; Sara B DeMauro; Lisa M Elden Journal: Ann Otol Rhinol Laryngol Date: 2020-08-14 Impact factor: 1.547
Authors: Mette Engan; Merete S Engeset; Lorentz Sandvik; Ole C O Gamlemshaug; Ingvild Ø Engesæter; Knut Øymar; Maria Vollsæter; Ola D Røksund; Karl Ove Hufthammer; Thomas Halvorsen; Hege H Clemm Journal: Front Pediatr Date: 2022-01-03 Impact factor: 3.418