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Pediatric Otolaryngology

(269) Injection Laryngoplasty for Children with Dysphagia After Cardiac Surgery

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Derek Sheen, MD

    PGY4
    University of Texas Southwestern Medical School
    Dallas, Texas, United States

    • Co-Author(s)

  • Sofia E. Olsson, BS

    Student
    Burnett School of Medicine at Texas Christian University
    Fort Worth, Texas, United States

  • Helene K. Dabbous, MD

    Pediatric Otolaryngology Fellow
    University of Texas Southwestern Medical School
    Beirut, Beyrouth, Lebanon

  • Romaine F. Johnson, MD, MPH

    Professor
    Univ of Texas Southwestern Med Ctr
    DALLAS, TX, United States

  • Yann-Fuu Kou, MD

    Assistant Professor
    University of Texas Southwestern Medical Center, Department of Otolaryngology
    Dallas, TX, United States

    • Senior Author(s)

  • Stephen R. Chorney, MD, MPH

    Assistant Professor, Department of Otolaryngology-Head & Neck Surgery
    University of Texas Southwestern Medical Center
    Dallas, Texas, United States

Disclosure(s):
Stephen R. Chorney, MD, MPH: No relevant relationships to disclose.
Romaine F. Johnson, MD, MPH: No relevant relationships to disclose.
Derek Sheen, MD: No relevant relationships to disclose.
Helene K. Dabbous, MD: No relevant relationships to disclose.
Sofia E. Olsson, BS: No relevant relationships to disclose.


Introduction: Children with unilateral vocal cord paralysis after cardiac surgery may frequently develop swallowing dysfunction. The benefit of injection laryngoplasty (IL) beyond conservative management remains poorly understood.

Methods: A case-control study included children ( < 18 years) between 2012 and 2022 with unilateral vocal cord paralysis after cardiac surgery. Improvement in swallowing function after IL versus observation was determined for children obtaining videofluoroscopic swallow studies (VFSS). The primary objective compared rates of aspiration resolution and secondary objectives assessed time to resolution on VFSS.

Results: A total of 33 children with left vocal cord paralysis after cardiac surgery met inclusion. Initial surgeries were N=9 (27%) patent ductus arteriosus ligations, N=8 (24%) aortic arch surgeries, N=9 (27%) surgeries for hypoplastic left heart syndrome, and N=7 (21%) other cardiac surgeries. The mean age at initial surgery was 4.6 months (SD: 10.3). All children had a VFSS obtained after surgery that confirmed aspiration. There were 17 children that obtained an IL at 29.0 months (SD: 17.8) after cardiac surgery and 16 children observed without IL procedure. No surgical complications after IL were noted. The rate of improvement in swallowing based on postoperative VFSS was N=14 (82%) for the IL group and N=10 (63%) for the control group P=.26. The time to VFSS resolution of aspiration for children that had was 11.5 months (SD: 11.8) in the observation group and 40.8 months (SD: 24.4) in the IL group (P=.001).

Conclusions: There is an unclear benefit of IL for resolving aspiration in children with unilateral vocal cord paralysis and after cardiac surgery. Future studies should continue to explore the utility for IL in managing dysphagia secondary to vocal cord paralysis.