Hamid Kamalipour, Ashkan Mowla, Maryam Hosseini Saadi, Hamid Reza Davari, Karmella Kamali
Med Sci Monit 2006; 12(5): CR206-209
Available online: 2006-05-01
Background: The aim of the study was to determine the incidence and severityof hoarseness and vocal cord dysfunction in 200 patients undergoing open heart surgery in Shiraz-Iran.Material/Methods: This study involved prospective evaluation of 200 patients who underwent open heartsurgery during the year 2003 in Shiraz University hospitals. All patients received the same standardanesthetic technique. In post-operative course, all patients were electively ventilated for variableperiods depending on several factors, at least until the morning after surgery. All patients underwentdirect laryngoscopy immediately after extubation by the otolaryngologist, and the existence and gradeof hoarseness was evaluated on a four-point scale 6 and 12 hours after extubation. Results: Two hundredpatients, 64.5% male and 35.5% female, with a mean age of 56.7 (S.D.=5.2) were evaluated. CABG was performedmost frequently and the mean duration of cold perfusion was 122 minutes (S.D.=15). CVP insertion, endotrachealintubation, sternotomy, and hypothermia were performed in all patients. Hoarseness was found to be presentin 17% of patients; all but one were rated to be grade one on the four-point scale. However, laryngoscopydid not reveal anything specific. Conclusions: The incidence of hoarseness in this study was 17%; similarseries reported as high as 32%. Vocal cord dysfunction never occurred in our study and hoarseness probablyresulted from intubation trauma. Although we found no case of nerve injury and cord dysfunction, vocalcord palsy as a rare cause of respiratory insufficiency in chest and neck surgeries must never be overlooked.
Keywords: Cardiac Surgical Procedures - adverse effects, Hoarseness - etiology, Intubation, Intratracheal - adverse effects, Laryngoscopy, Prospective Studies