Faculty Collaboration Database

Resolution of vocal fold immobility in preterm infants. Int J Pediatr Otorhinolaryngol 2017 Dec;103:83-86

Date

12/12/2017

Pubmed ID

29224772

DOI

10.1016/j.ijporl.2017.10.007

Scopus ID

2-s2.0-85031278871 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

INTRODUCTION: Vocal fold immobility (VFI) is an important sequela of preterm birth due to patent ductus arteriosus (PDA) ligation and invasive ventilation. A minority of these patients experience VFI resolution. The purpose of this study is to determine factors associated with VFI resolution in preterm infants.

METHODS: This is a case control study of preterm (<37 weeks gestation) infants admitted to a metropolitan Level IV neonatal intensive care unit from 2006 to 2012. All patients diagnosed with VFI by flexible nasolaryngoscopy were divided into 2 cohorts: those with and without laryngoscopic resolution of VFI during follow-up. Univariate and multivariate analyses were performed to determine factors associated with VFI resolution.

RESULTS: Of 71 patients with VFI and adequate follow-up, 17 (23.9%) experienced resolution. Median (range) follow-up was 25.7 (0.4-91.3) months and time to resolution 4.4 (0.4-38.8) months. Compared to the ongoing-VFI cohort, those who experienced resolution had higher median gestational age (31 vs 25 weeks, p = 0.006) and birth weight (1550 vs 765 g, p = 0.02), and lower likelihood of undergoing PDA ligation (47.1% vs 77.8%, p = 0.02). On multivariate analysis, history of PDA ligation remained independently associated with a lower likelihood of VFI resolution (p = 0.02, OR 0.2, 95% CI 0.1-0.8). Among PDA ligation patients, birth weight >1000 g was more common in the resolution cohort compared to the ongoing-VFI cohort (62.5% vs 24.4%, p = 0.047).

CONCLUSION: While lower birth weight and gestational age are known risk factors for VFI following PDA ligation, in this study, these factors were also associated with a decreased likelihood of VFI resolution. Furthermore, PDA ligation appears to be a risk for both the development and persistence of VFI. This evidence should inform prognosis and intervention decisions for preterm infants with VFI.

Author List

Jabbour J, Robey T

Author

Thomas C. Robey MD Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Case-Control Studies
Ductus Arteriosus, Patent
Female
Follow-Up Studies
Gestational Age
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Laryngoscopy
Ligation
Male
Postoperative Complications
Prognosis
Risk Factors
Vocal Cord Paralysis
Vocal Cords