Pereira Kevin D, Webb Benjamin D, Blakely Martin L, Cox Charles S, Lally Kevin P
Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center at Houston, United States.
Int J Pediatr Otorhinolaryngol. 2006 Sep;70(9):1609-12. doi: 10.1016/j.ijporl.2006.05.001. Epub 2006 Jun 21.
To prospectively study the clinical course of neonates with vocal cord paralysis (VCP) after patent ductus arteriosus (PDA) ligation.
A prospective cohort study of all premature infants undergoing PDA ligation from March 2001 to February 2004. Flexible laryngoscopy was performed after extubation to assess vocal cord function. Data regarding patient characteristics, operative findings, post-operative endoscopic findings, and the subsequent clinical course were collected.
One hundred patients were enrolled. Flexible laryngoscopy was performed on 61 patients. Median birth weight was 740 g, gestational age 25 weeks, and age at operation 23 days. Flexible laryngoscopy was performed at an average of 8 days after extubation. Seven cases of vocal cord paralysis were identified. Two had stridor and feeding difficulty requiring nasogastric feeding. Five of the seven had an average follow-up of 9 months after surgery. At last follow-up, endoscopically satisfactory compensation by the normal vocal cord was observed in all five patients. No patient had feeding problems.
The majority of infants who can be successfully extubated after PDA ligation tend to be asymptomatic despite vocal cord paralysis. Compensation appears to occur rapidly, and patients generally have no *long-term problems with the airway or feeding.
前瞻性研究动脉导管未闭（PDA）结扎术后新生儿声带麻痹（VCP）的临床病程。
对2001年3月至2004年2月期间所有接受PDA结扎术的早产儿进行前瞻性队列研究。拔管后进行纤维喉镜检查以评估声带功能。收集有关患者特征、手术结果、术后内镜检查结果及后续临床病程的数据。
共纳入100例患者。对61例患者进行了纤维喉镜检查。中位出生体重为740g，胎龄25周，手术时年龄为23天。纤维喉镜检查平均在拔管后8天进行。发现7例声带麻痹。2例有喘鸣和喂养困难，需要鼻饲。7例中的5例术后平均随访9个月。在最后一次随访时，所有5例患者内镜检查显示正常声带均有令人满意的代偿。无患者有喂养问题。
大多数PDA结扎术后能成功拔管的婴儿，尽管有声带麻痹但往往无症状。代偿似乎迅速发生，患者一般在气道或喂养方面无长期问题。
