title: Ultrasonography assessment of vocal cords mobility in children after cardiac surgery.
abstract: OBJECTIVE
  Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL).
  
  
  METHODS
  A prospective pilot study has been conducted in Pediatric Cardiac ICU (PCICU) at King Abdulaziz Cardiac Center (KACC) from the 1st of June 2009 till the end of July 2010. Patients who had cardiac surgery manifested with significant signs of upper airway obstruction were included. Each procedure was performed by different operators who were blinded to each other report. Results of invasive (FL) and non-invasive ultrasonography (US) investigations were compared.
  
  
  RESULTS
  Ten patients developed persistent significant upper airway obstruction after cardiac surgery were included in the study. Their mean ± SEM of weight and age were 4.6 ± 0.4 kg and 126.4 ± 51.4 days, respectively. All patients were referred to bedside US screening for vocal cord mobility. The results of US were compared subsequently with FL findings. Results were identical in nine (90%) patients and partially different in one (10%). Six patients showed abnormal glottal movement while the other four patients demonstrated normal vocal cords mobility by FL. Sensitivity of US was 100% and specificity of 80%.
  
  
  CONCLUSIONS
  US assessment of vocal cord is simple, non-invasive and reliable tool to assess vocal cords mobility in the critical care settings. This screening tool requires skills that can be easily obtained.
authors: Cardiac Science Department, King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Mail Code 1420, P.O. Box 22490, Riyadh 11426.
authors: Ghassan A
authors: GA
authors: Shaath
authors: Abdulraouf
authors: A
authors: Jijeh
authors: Ahmad
authors: A
authors: Alkurdi
authors: Sameh
authors: S
authors: Ismail
authors: Mahmoud
authors: M
authors: Elbarbary
authors: Mohamed S
authors: MS
authors: Kabbani
keywords: Pediatric cardiac surgery; Ultrasonography; Vocal cord
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