Recurrent laryngeal nerve palsy after cardiovascular surgery: Relationship to the placement of a transesophageal echocardiographic probe

Abstract

Objective: To examine the relationship between the incidence of recurrent laryngeal nerve palsy after cardiovascular surgery and the placement of a transesophageal echocardiographic probe. Design: A prospective clinical study. Setting: A single-institutional study in a university hospital. Participants: One hundred sixteen patients undergoing cardiovascular surgery. Interventions: All patients were assigned into one of two groups: 64 patients in whom transesophageal echocardiography (TEE) was performed and 52 patients in whom TEE was not performed during surgery. The incidence of recurrent laryngeal nerve palsy was examined and compared between the two groups. Measurements and Main Results: Five of 64 patients (7.8%) in whom TEE was monitored and 3 of 52 patients (5.8%) in whom TEE was not monitored were diagnosed with recurrent laryngeal nerve palsy postoperatively. There was no statistically significant difference between the incidence of recurrent laryngeal nerve palsy in patients with intraoperative TEE monitoring, and patients without it. The durations of surgery, anesthesia, and cardiopulmonary bypass were significantly longer in patients with nerve palsy than those without it. Conclusion: These results suggest that placement of the transesophageal echocardiographic probe is not responsible for postoperative recurrent laryngeal nerve palsy. It seems likely that surgical manipulation itself and the durations of surgery, cardiopulmonary bypass, and tracheal intubation are related to the incidence of laryngeal nerve palsy.