Incidence of Recurrent Laryngeal Nerve Palsy in Thoracic Surgery in Neonates

Khaled Al Tabaa¹, Matthias Claire², Arnaud Bonnard³, Souhayl Dahmani⁴, Thierry Van Den Abbeele⁵, Natacha Teissier⁶, Emilie Bois⁷

Affiliations

¹ Otolaryngology-Head and Neck Surgery Department, Hôpital NOVO, 6 Avenue de l'Ile de France, 95300, Pontoise, France; CY Cergy Paris University, ERREMECe, 95000, Cergy Pontoise, France. Electronic address: e-kaltabaa@etu.cyu.fr.
² Otolaryngology-Head and Neck Surgery Department, Hôpital NOVO, 6 Avenue de l'Ile de France, 95300, Pontoise, France. Electronic address: m.claire456@gmail.com.
³ Pediatric Surgery Department, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris Cité University, 75019, Paris, France; Université de Paris, INSERM U1141 NeuroDiderot, Inserm, 75019, Paris, France. Electronic address: arnaud.bonnard@aphp.fr.
⁴ Anesthesiology Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France. Electronic address: souhayl.dahmani@aphp.fr.
⁵ Otolaryngology-Head and Neck Surgery Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France; Université de Paris, INSERM U1141 NeuroDiderot, Inserm, 75019, Paris, France.
⁶ Otolaryngology-Head and Neck Surgery Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France; Université de Paris, INSERM U1141 NeuroDiderot, Inserm, 75019, Paris, France. Electronic address: natacha.teissier@aphp.fr.
⁷ Otolaryngology-Head and Neck Surgery Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France.

PMID: 40316247
DOI: 10.1016/j.jpedsurg.2025.162357

Review

Incidence of Recurrent Laryngeal Nerve Palsy in Thoracic Surgery in Neonates

Khaled Al Tabaa et al. J Pediatr Surg. 2025 Aug.

. 2025 Aug;60(8):162357.

doi: 10.1016/j.jpedsurg.2025.162357. Epub 2025 Apr 30.

Authors

Khaled Al Tabaa¹, Matthias Claire², Arnaud Bonnard³, Souhayl Dahmani⁴, Thierry Van Den Abbeele⁵, Natacha Teissier⁶, Emilie Bois⁷

Affiliations

¹ Otolaryngology-Head and Neck Surgery Department, Hôpital NOVO, 6 Avenue de l'Ile de France, 95300, Pontoise, France; CY Cergy Paris University, ERREMECe, 95000, Cergy Pontoise, France. Electronic address: e-kaltabaa@etu.cyu.fr.
² Otolaryngology-Head and Neck Surgery Department, Hôpital NOVO, 6 Avenue de l'Ile de France, 95300, Pontoise, France. Electronic address: m.claire456@gmail.com.
³ Pediatric Surgery Department, Hôpital Robert Debré, 48 Boulevard Sérurier, Paris Cité University, 75019, Paris, France; Université de Paris, INSERM U1141 NeuroDiderot, Inserm, 75019, Paris, France. Electronic address: arnaud.bonnard@aphp.fr.
⁴ Anesthesiology Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France. Electronic address: souhayl.dahmani@aphp.fr.
⁵ Otolaryngology-Head and Neck Surgery Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France; Université de Paris, INSERM U1141 NeuroDiderot, Inserm, 75019, Paris, France.
⁶ Otolaryngology-Head and Neck Surgery Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France; Université de Paris, INSERM U1141 NeuroDiderot, Inserm, 75019, Paris, France. Electronic address: natacha.teissier@aphp.fr.
⁷ Otolaryngology-Head and Neck Surgery Department, Hôpital Robert Debré, Paris Cité University, 48 Boulevard Sérurier, 75019, Paris, France.

PMID: 40316247
DOI: 10.1016/j.jpedsurg.2025.162357

Abstract

Objective: Postoperative vocal cord paralysis (VCP) is a known complication of thoracic surgeries that carry a risk of recurrent laryngeal nerve (RLN) injury. The primary aims of this study were to evaluate the prevalence of postoperative VCP, identify associated risk factors, and assess the impact on feeding and length of hospital stay in pediatric thoracic surgery.

Materials and methods: We conducted a prospective, interventional, single-center study from September 2020 to January 2022. Preoperative laryngeal fibroscopy was performed, and children with pre-existing laryngeal immobility were excluded. Postoperative laryngeal fibroscopy was systematically performed 15 days after surgery to assess the incidence of VCP. Data were compared between children with and without VCP to identify risk factors and evaluate the impact on feeding and hospital length of stay.

Results: During the study period, 17 children (mean age 3.2 days; mean weight 2628 g) who underwent thoracic surgery at risk of RLN injury were included: 15 for esophageal atresia, 1 for ductus arteriosus ligation, and 1 for aortic arch surgery. Of these, 4 children were excluded because they could not undergo laryngoscopy at day 15. Postoperative fibroscopy was performed in the remaining 13 children, revealing VCP in 5 (38.5%). VCP was always symptomatic, with stridor requiring specific management in 2 patients. Weight and gestational age emerged as significant factors influencing the risk of postoperative VCP, while associated malformations did not impact VCP risk. No major effects on feeding or length of hospital stay were observed.

Conclusion: VCP is a common complication of thoracic surgery in children, highlighting the importance of its prevention due to potential severe consequences. Further research is needed to refine strategies for preventing VCP and improving outcomes in this patient population.

Keywords: Esophageal atresia; Infants; Thoracic surgery; laryngeal nerve palsy.

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Conflict of interest All authors declare no conflicts of interest.

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Incidence of Recurrent Laryngeal Nerve Palsy in Thoracic Surgery in Neonates

Affiliations

Incidence of Recurrent Laryngeal Nerve Palsy in Thoracic Surgery in Neonates

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous