Vocal Fold Mobility Impairment Following Cardiovascular Surgery: Incidence, Risk Factors and Sequela.

Abstract Background We aimed to determine the incidence and contributing risk factors of vocal fold mobility impairment (VFMI) in postoperative cardiovascular patients and evaluate the impact of VFMI on health-related outcomes. Methods A single-site prospective study in adults undergoing sternotomy or thoracotomy procedures were enrolled who underwent a fiberoptic laryngoscopy exam within 72 hours of extubation. Potential demographic and surgical risk factors and health-related outcomes were collected. A blinded laryngologist assessed VFMI and mucosal injury. Descriptives, univariate and multivariable regression analyses were performed. Results In 185 eligible exams, VFMI was confirmed in 25% of patients (7 complete, 39 partial VFMI) with left sided involvement in 83% of cases. Laryngeal mucosal injury included granuloma (38%), posterior cricoid hypertrophy (37%), edema (29%), bruising (23%), and hemorrhage (9%). Independent risk factors for complete VFMI were: aortic arch procedure (OR: 6.1), body mass index > 2 identified risk factors had a 33.0 increased odds of complete VFMI compared to those without. Compared to patients with normal vocal fold motion, patients with complete VFMI experienced a 2.7 increased odds of pneumonia, 5.7 higher odds of reintubation, a 7.3 times higher odds of death, and increased length of hospital stay and cost of care, p Conclusions Interdisciplinary postoperative care and laryngoscopy examination is recommended in high-risk patients to facilitate early detection and improve patient outcomes.