Recovery of vocal fold paralysis after cardiovascular surgery.

OBJECTIVES/HYPOTHESIS To review the incidence and time course of recovery of vocal fold paralysis (VFP) in adult patients after cardiovascular surgery. STUDY DESIGN Retrospective cohort study of adults after cardiovascular surgery at a tertiary care academic medical center. METHODS Patients with VFP after cardiovascular surgery were identified from a database of hospitalized patients undergoing voice and swallow evaluation. VFP was confirmed using transnasal fiberoptic laryngoscopy within 1 week of surgery. Follow-up laryngoscopy was performed in those with VFP in the outpatient clinic. Those with persistent paralysis were followed and the time course of recovery was noted. RESULTS Eighty-six adult postoperative cardiovascular surgery patients (ages 34 to 83 years, mean 68) were identified from the inpatient voice and swallowing evaluation database. There were 20 patients (23%) with unilateral VFP. Thirteen patients followed-up for outpatient laryngoscopy. Ten of the thirteen patients (77%) ultimately had complete resolution of VFP. Three patients had persistent paralysis at a mean follow-up of 18 months. There was no obvious correlation between type of cardiovascular surgery and VFP. Signs of recovery were generally evident prior to 6 months and no recovery was seen beyond 12 months. CONCLUSIONS Most patients with VFP after cardiovascular surgery recover fully. In accordance with previous laryngeal electromyography findings, neuropraxia during cardiovascular surgery will usually recover within 6 months.