title: Recovery of vocal fold immobility following isolated patent ductus arteriosus ligation.
abstract: OBJECTIVE
  Identify laryngoscopic and functional outcomes of infants with vocal fold immobility (VFI) following patent ductus arteriosus (PDA) ligation and identify predictors of recovery.
  
  
  METHODS
  Retrospective review of patients with VFI following PDA ligation from 2001 to 2012 at a single institution. Inclusion criteria were: (1) PDA ligation as only cardiac surgical procedure; (2) left VFI documented by laryngoscopy; (3) minimum follow up 120 days, with at least 2 laryngoscopies performed. Resolution of VFI was determined at follow-up laryngoscopy. Univariate logistic regression models were used to identify variables associated with VFI recovery.
  
  
  RESULTS
  66 subjects were included with median follow up of 3.0 (± 2.1) years. The mean gestational age was 24.5 ± 1.4 weeks, mean birth weight 673 ± 167 g, and mean age at procedure was 18.6 ± 14.3 days. Patients presented with respiratory symptoms (39%), dysphonia (78%) and dysphagia (55%). Resolution of VFI was observed in 2/66 (3%) patients. Recovery was documented at 20 days and 11 months respectively. Respiratory symptoms, dysphagia, and dysphonia persisted at last follow up in 11%, 47%, and 20% of patients.
  
  
  CONCLUSIONS
  VFI associated with ligation of the ductus arteriosus has a low rate of recovery. Clinical symptoms frequently persist, and as such regular follow-up by otolaryngologists to mitigate morbidity is indicated.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Brent G
authors.initials: BG
authors.lastname: Nichols
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Jad
authors.initials: J
authors.lastname: Jabbour
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Hehir
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Ghanayem
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Beste
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Martin
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Woods
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: trobey@mcw.edu.
authors.forename: Thomas
authors.initials: T
authors.lastname: Robey
mesh_terms: D002675:Child, Preschool; D003680:Deglutition Disorders / Q000209:etiology; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D055154:Dysphonia / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D007828:Laryngoscopy; D008026:Ligation; D020127:Recovery of Function; D061226:Recurrent Laryngeal Nerve Injuries / Q000150:complications / Q000209:etiology; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies; D014826:Vocal Cord Paralysis / Q000209:etiology*; D014939:Work of Breathing