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Clinical Investigations: SURGERY |

Vocal Cord Paralysis After Surgery for Thoracic Aortic Aneurysm*

Shin-ichi Ishimoto, MD; Ken Ito, MD; Masaaki Toyama, MD; Isamu Kawase, MD; Kenji Kondo, MD; Kiyoshi Oshima, MD; Seiji Niimi, MD
Author and Funding Information

*From the Department of Otolaryngology (Drs. Ishimoto, Ito, and Niimi), Faculty of Medicine, University of Tokyo, Tokyo; the Division of Otorhinolaryngology (Dr. Kondo) and the Division of Cardiovascular Surgery (Drs. Toyama and Kawase), Kameda Medical Center, Kamogawa; and the Department of Otolaryngology (Dr. Oshima), Tokyo Teishin Hospital, Tokyo, Japan.

Correspondence to: Ken Ito, MD, Department of Otolaryngology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; e-mail: itoken-tky@umin.ac.jp



Chest. 2002;121(6):1911-1915. doi:10.1378/chest.121.6.1911
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Objective: To determine the incidence, etiology, prognosis, and treatment of vocal cord paralysis (VCP) after surgery for thoracic aortic aneurysm (TAA).

Study design: Retrospective study performed between 1989 and 1995.

Setting: Academic, tertiary care, referral medical center.

Patients: Seventy-one TAA patients underwent surgery at the Kameda Medical Center between 1989 and 1995.

Results: Sixty-two of 71 patients were examined postoperatively for voice quality. Twenty patients (32%) had hoarseness develop caused by VCP, as confirmed by laryngoscopy. The left recurrent laryngeal nerve had been sacrificed in 1 patient during surgery, but it was preserved in the remaining 19 patients. Unilateral left VCP was noted in 19 patients, and bilateral VCP occurred in 1 patient. The incidence of VCP was higher in those patients who underwent surgery for type I aneurysms (9 of 14 patients, 64%). In 16 of the 19 patients (84%) who received follow-up for > 6 months, vocal cord movement did not return to normal. Surgery to improve voice quality, arytenoid adduction in five patients and intracordal injection in two patients, was performed with success.

Conclusions: Our results indicate that surgery for TAA is associated with a relatively high incidence of VCP. VCP occurred despite preservation of the recurrent laryngeal nerve, and the paralysis did not show a spontaneous recovery even 6 months after surgery.

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