Department of Cardiothoracic Surgery, Fujian Medical University, Putian, China.
Cardiol J. 2012;19(6):560-6. doi: 10.5603/cj.2012.0106.
The clinical characteristics and outcomes of hoarseness subsequent to cardiovascular surgery, intervention, maneuver and endotracheal intubation have not been systematically elucidated.
The literature of hoarseness following cardiovascular surgery, intervention, and maneuver and intubation published between 1980 and 2011 was comprehensively retrieved in the MEDLINE database and the Google and Highwire Press search engines.
The so-called "iatrogenic Ortner's (cardiovocal) syndrome" developed 0-7 (2.33 ± ± 2.66) days following cardiovascular surgery, intervention, maneuver and endotracheal intubation with an incidence of 10.15%. The most common symptoms associated with hoarseness were stridor (49.45%) and aspiration (15.38%). Patent ductus arteriosus ligation and otherwise congenital heart disease repair were the two main causes leading to such a complication. Patients' hoarse voice spontaneously resolved in 70.52%, and persisted in 33.61% of the patients. Treatment of the hoarseness included gelfoam/teflon injection, intravenous steroid therapy, type 1 thyroplasty and arytenoid adduction. Hoarseness recovered in 46.67%, improved in 13.33%, and persisted in 40%.
The recurrent laryngeal nerve was often injured following cardiovascular surgery, intervention, maneuver and endotracheal intubation. Care must be taken during the manipulations in order to avoid the nerve injury. The so-called "iatrogenic Ortner's (cardiovocal) syndrome" was a wrong concept as it did not meet the satisfaction of a main element "cardiovascular disease as an underlying cause of hoarseness" of the definition of Ortner's (cardiovocal) syndrome defined by Ortner in 1897. It was actually an immediate vocal cord complication following cardiovascular manipulation.
心血管手术后、介入治疗、操作和气管插管后声音嘶哑的临床特征和转归尚未得到系统阐明。
在 MEDLINE 数据库和 Google 和 Highwire Press 搜索引擎中全面检索了 1980 年至 2011 年间发表的心血管手术、介入治疗和操作以及插管后声音嘶哑的文献。
所谓的“医源性 Ortner（心音）综合征”在心血管手术、介入治疗、操作和气管插管后 0-7（2.33±±2.66）天发展，发生率为 10.15%。与声音嘶哑相关的最常见症状是喘鸣（49.45%）和吸入（15.38%）。动脉导管未闭结扎术和其他先天性心脏病修复术是导致这种并发症的两个主要原因。患者的声音嘶哑自行缓解 70.52%，持续存在 33.61%。声音嘶哑的治疗包括明胶海绵/特氟隆注射、静脉类固醇治疗、1 型甲状软骨成形术和杓状软骨内收术。声音嘶哑恢复 46.67%，改善 13.33%，持续存在 40%。
心血管手术、介入治疗、操作和气管插管后常损伤喉返神经。操作过程中必须小心，避免神经损伤。所谓的“医源性 Ortner（心音）综合征”是一个错误的概念，因为它不符合 Ortner 于 1897 年定义的 Ortner（心音）综合征的定义中“声音嘶哑的潜在病因是心血管疾病”这一主要要素。它实际上是心血管操作后立即出现的声带并发症。
