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Hospitalized Patients With New-Onset Vocal Fold Immobility Warrant Inpatient Injection Laryngoplasty.
Laryngoscope. 2020 Mar 16 [Online ahead of print]L

Abstract

OBJECTIVES

To evaluate the impact of early inpatient bedside injection laryngoplasty (IL) in hospitalized patients with iatrogenic unilateral vocal fold immobility (UVFI).

STUDY DESIGN

Retrospective cohort study.

METHODS

A retrospective review of hospitalized patients with iatrogenic UVFI undergoing IL between September 2013 and June 2017 was performed. Patients had a swallow evaluation by a speech-language pathologist and bedside IL. Evaluated outcomes included swallow scores, return to diet, secondary events/procedures, and hospital length of stay. Outcomes related to etiology of UVFI were also examined.

RESULTS

The cohort consisted of 90 patients (61% male, 52% after cardiac/cardiothoracic surgery). Seventy-seven percent of all patients who could improve had increased swallow scores after IL. The lowest number (40%) from the subgroup of patients with high vagal injuries as the cause of UVFI obtained improvement in swallow scores, whereas 87% of those in the cardiac surgery group improved. There were more bronchoscopies and reintubations in patients before IL than after IL.

CONCLUSION

Hospitalized patients with UVFI are at increased risk of morbidity and mortality due to dysphagia. We advocate for early swallow evaluation and intervention with IL if there is dysphagia and risk of aspiration. Coordination of care between interdisciplinary teams is paramount to a successful inpatient IL program.

LEVEL OF EVIDENCE

2b Laryngoscope, 2020.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32176334

Citation

Reder, Lindsay, et al. "Hospitalized Patients With New-Onset Vocal Fold Immobility Warrant Inpatient Injection Laryngoplasty." The Laryngoscope, 2020.
Reder L, Bertelsen C, Angajala V, et al. Hospitalized Patients With New-Onset Vocal Fold Immobility Warrant Inpatient Injection Laryngoplasty. Laryngoscope. 2020.
Reder, L., Bertelsen, C., Angajala, V., O'Dell, K., & Fisher, L. (2020). Hospitalized Patients With New-Onset Vocal Fold Immobility Warrant Inpatient Injection Laryngoplasty. The Laryngoscope. https://doi.org/10.1002/lary.28606
Reder L, et al. Hospitalized Patients With New-Onset Vocal Fold Immobility Warrant Inpatient Injection Laryngoplasty. Laryngoscope. 2020 Mar 16; PubMed PMID: 32176334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospitalized Patients With New-Onset Vocal Fold Immobility Warrant Inpatient Injection Laryngoplasty. AU - Reder,Lindsay, AU - Bertelsen,Caitlin, AU - Angajala,Varun, AU - O'Dell,Karla, AU - Fisher,Laurel, Y1 - 2020/03/16/ PY - 2019/10/06/received PY - 2020/01/04/revised PY - 2020/02/13/accepted PY - 2020/3/17/entrez KW - Injection laryngoplasty KW - aspiration KW - dysphagia KW - injection augmentation KW - vocal fold paralysis JF - The Laryngoscope JO - Laryngoscope N2 - OBJECTIVES: To evaluate the impact of early inpatient bedside injection laryngoplasty (IL) in hospitalized patients with iatrogenic unilateral vocal fold immobility (UVFI). STUDY DESIGN: Retrospective cohort study. METHODS: A retrospective review of hospitalized patients with iatrogenic UVFI undergoing IL between September 2013 and June 2017 was performed. Patients had a swallow evaluation by a speech-language pathologist and bedside IL. Evaluated outcomes included swallow scores, return to diet, secondary events/procedures, and hospital length of stay. Outcomes related to etiology of UVFI were also examined. RESULTS: The cohort consisted of 90 patients (61% male, 52% after cardiac/cardiothoracic surgery). Seventy-seven percent of all patients who could improve had increased swallow scores after IL. The lowest number (40%) from the subgroup of patients with high vagal injuries as the cause of UVFI obtained improvement in swallow scores, whereas 87% of those in the cardiac surgery group improved. There were more bronchoscopies and reintubations in patients before IL than after IL. CONCLUSION: Hospitalized patients with UVFI are at increased risk of morbidity and mortality due to dysphagia. We advocate for early swallow evaluation and intervention with IL if there is dysphagia and risk of aspiration. Coordination of care between interdisciplinary teams is paramount to a successful inpatient IL program. LEVEL OF EVIDENCE: 2b Laryngoscope, 2020. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/32176334/Hospitalized_Patients_With_New-Onset_Vocal_Fold_Immobility_Warrant_Inpatient_Injection_Laryngoplasty L2 - https://doi.org/10.1002/lary.28606 DB - PRIME DP - Unbound Medicine ER -
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