Our Summary

This research paper looks at the risk of infants developing swallowing difficulties and vocal fold motion impairment (VFMI) after heart surgery. The study reviewed the medical records of 374 infants who had heart surgery between 2008 and 2018. They found that 60% of these infants had trouble swallowing food from the mouth (oral dysphagia), and 64% had trouble swallowing from the throat (pharyngeal dysphagia). Additionally, 51% of them had food or liquid entering their voice box (laryngeal penetration), and 45% had food or liquid going into their windpipe (tracheal aspiration) - 73% of these aspirations happened without coughing or any noticeable signs (silent aspiration). Interestingly, the complexity of the heart surgery didn’t seem to impact these results. However, infants who developed VFMI after the surgery were almost twice as likely to experience silent aspiration. This research highlights the importance of carefully monitoring swallowing function in infants after heart surgery.

FAQs

  1. What percentage of infants developed swallowing difficulties after heart surgery, according to the study?
  2. Did the complexity of the heart surgery have any impact on the development of swallowing difficulties and VFMI in infants?
  3. What is the significance of VFMI in regard to silent aspiration post-heart surgery in infants?

Doctor’s Tip

A doctor might tell a patient undergoing vocal cord surgery to follow post-operative care instructions closely, including rest, vocal rest, and proper hydration. They may also recommend working with a speech therapist to help with vocal rehabilitation and strengthening exercises. It is important to give your vocal cords time to heal properly in order to avoid complications and achieve the best possible outcome.

Suitable For

Patients who are typically recommended vocal cord surgery include those with vocal cord paralysis, vocal nodules, vocal polyps, vocal cord cysts, laryngeal cancer, or other structural abnormalities of the vocal cords. Additionally, patients with severe hoarseness, difficulty swallowing, chronic cough, or other voice and swallowing disorders may also be candidates for vocal cord surgery. It is important for patients to undergo a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) to determine if vocal cord surgery is the appropriate treatment option for their condition.

Timeline

Before vocal cord surgery:

  • Patient experiences symptoms such as hoarseness, voice fatigue, difficulty breathing, or changes in voice pitch
  • Patient undergoes a thorough evaluation by an otolaryngologist, which may include a physical examination, laryngoscopy, and possibly imaging tests
  • Otolaryngologist discusses treatment options with the patient, including the risks and benefits of vocal cord surgery
  • Patient may undergo pre-operative testing to ensure they are healthy enough for surgery

After vocal cord surgery:

  • Patient undergoes vocal cord surgery, which may involve procedures such as vocal cord injection, medialization laryngoplasty, or vocal cord microsurgery
  • Patient is monitored closely post-operatively for complications such as bleeding, infection, or changes in voice quality
  • Patient may experience temporary hoarseness or voice changes as the vocal cords heal
  • Patient undergoes voice therapy to help improve vocal function and prevent future vocal cord issues
  • Patient follows up with their otolaryngologist for regular check-ups to monitor their vocal cord health and address any ongoing concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vocal cord surgery?
  2. How experienced are you in performing this type of surgery?
  3. What is the success rate of this surgery for patients with similar conditions?
  4. What is the expected recovery time and post-operative care plan?
  5. Are there any alternative treatments or therapies that could be considered instead of surgery?
  6. What are the potential long-term effects or changes in voice quality after the surgery?
  7. How will the surgery impact my ability to swallow and speak?
  8. What are the potential risks of anesthesia for this surgery?
  9. How soon after the surgery can I expect to see improvement in my vocal cord function?
  10. Are there any lifestyle changes or precautions I should take after the surgery to ensure the best possible outcome?

Reference

Authors: Narawane A, Rappazzo C, Hawney J, Clason H, Roddy DJ, Ongkasuwan J. Journal: Laryngoscope. 2022 Mar;132(3):701-705. doi: 10.1002/lary.29817. Epub 2021 Aug 11. PMID: 34378798