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Resolution of vocal fold immobility in preterm infants.

Abstract Vocal fold immobility (VFI) is an important sequela of preterm birth due to patent ductus arteriosus (PDA) ligation and invasive ventilation. A minority of these patients experience VFI resolution. The purpose of this study is to determine factors associated with VFI resolution in preterm infants.
PMID
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Authors

Mayor MeshTerms
Keywords

Laryngology

Patent ductus arteriosus ligation

Preterm birth

Vocal cord paralysis

Vocal fold immobility

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 29224772
OWN - NLM
STAT- In-Process
LR  - 20171211
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 103
DP  - 2017 Dec
TI  - Resolution of vocal fold immobility in preterm infants.
PG  - 83-86
LID - S0165-5876(17)30470-6 [pii]
LID - 10.1016/j.ijporl.2017.10.007 [doi]
AB  - INTRODUCTION: Vocal fold immobility (VFI) is an important sequela of preterm
      birth due to patent ductus arteriosus (PDA) ligation and invasive ventilation. A 
      minority of these patients experience VFI resolution. The purpose of this study
      is to determine factors associated with VFI resolution in preterm infants.
      METHODS: This is a case control study of preterm (<37 weeks gestation) infants
      admitted to a metropolitan Level IV neonatal intensive care unit from 2006 to
      2012. All patients diagnosed with VFI by flexible nasolaryngoscopy were divided
      into 2 cohorts: those with and without laryngoscopic resolution of VFI during
      follow-up. Univariate and multivariate analyses were performed to determine
      factors associated with VFI resolution. RESULTS: Of 71 patients with VFI and
      adequate follow-up, 17 (23.9%) experienced resolution. Median (range) follow-up
      was 25.7 (0.4-91.3) months and time to resolution 4.4 (0.4-38.8) months. Compared
      to the ongoing-VFI cohort, those who experienced resolution had higher median
      gestational age (31 vs 25 weeks, p = 0.006) and birth weight (1550 vs 765 g, p = 
      0.02), and lower likelihood of undergoing PDA ligation (47.1% vs 77.8%, p =
      0.02). On multivariate analysis, history of PDA ligation remained independently
      associated with a lower likelihood of VFI resolution (p = 0.02, OR 0.2, 95% CI
      0.1-0.8). Among PDA ligation patients, birth weight >1000 g was more common in
      the resolution cohort compared to the ongoing-VFI cohort (62.5% vs 24.4%, p =
      0.047). CONCLUSION: While lower birth weight and gestational age are known risk
      factors for VFI following PDA ligation, in this study, these factors were also
      associated with a decreased likelihood of VFI resolution. Furthermore, PDA
      ligation appears to be a risk for both the development and persistence of VFI.
      This evidence should inform prognosis and intervention decisions for preterm
      infants with VFI.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Jabbour, Jad
AU  - Jabbour J
AD  - Department of Otolaryngology and Communication Enhancement, Boston Children's
      Hospital/Harvard Medical School, 300 Longwood Ave, BCH 3129, Boston, MA 02115,
      USA. Electronic address: [email protected]
FAU - Robey, Thomas
AU  - Robey T
AD  - Department of Otolaryngology and Communication Sciences, Medical College of
      Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA; Division of
      Pediatric Otolaryngology, Children's Hospital of Wisconsin, 8915 W Connell Ct,
      Milwaukee, WI 53226, USA. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20171010
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
OTO - NOTNLM
OT  - Laryngology
OT  - Patent ductus arteriosus ligation
OT  - Preterm birth
OT  - Vocal cord paralysis
OT  - Vocal fold immobility
EDAT- 2017/12/12 06:00
MHDA- 2017/12/12 06:00
CRDT- 2017/12/12 06:00
PHST- 2017/06/11 00:00 [received]
PHST- 2017/08/22 00:00 [revised]
PHST- 2017/10/03 00:00 [accepted]
PHST- 2017/12/12 06:00 [entrez]
PHST- 2017/12/12 06:00 [pubmed]
PHST- 2017/12/12 06:00 [medline]
AID - S0165-5876(17)30470-6 [pii]
AID - 10.1016/j.ijporl.2017.10.007 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 Dec;103:83-86. doi:
      10.1016/j.ijporl.2017.10.007. Epub 2017 Oct 10.