{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:23:35Z","timestamp":1783034615224,"version":"3.54.6"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Vocal fold movement impairment (VFMI) secondary to neuronal injury is a known risk after aortic surgery. Total arch replacement is technically challenging, and the incidence of vocal fold movement impairment secondary to neuronal injury after this surgery is unknown. This study examined the incidence of VFMI after total arch replacement and medialization treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent total arch replacement at a tertiary care center over 11 years (2006\u20132017) were identified through an institutional database. End points included evidence of VFMI on flexible laryngoscopy, time to diagnosis, time to treatment, need for reintubation, and intensive care unit (ICU) and hospital length of stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 358 patients who underwent total arch replacement, 63 (20%) were diagnosed with VFMI during their initial inpatient stay. Fifty patients (79%) VFMIs were left\u2010sided, nine (14%) were right\u2010sided, and four (6%) were bilateral. Thirty\u2010nine patients (62%) underwent inpatient vocal fold medialization: 28 (72%) by injection laryngoplasty and 11 (28%) by type 1 thyroplasty. Those with unilateral VFMI had longer ICU (8.9 days) and hospital (19.4 days) than those with no VFMI (5.7 and 16.1 days). Among patients with unilateral VFMI, those who underwent inpatient vocal fold medialization trended toward shorter ICU (6.2 vs. 14.4 days, <jats:italic>P<\/jats:italic>\u2009=\u2009.03) and hospital stays (20.1 vs. 23.3 days, <jats:italic>P<\/jats:italic>\u2009=\u2009.4) than patients who did not have a medialization procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The overall incidence of VFMI after total arch replacement in our series was 20%. Both the right and left vocal folds are potentially at risk from a total arch replacement; consequently, the distribution of injury in our cohort was more heterogeneous than in other series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 129:699\u2013703, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27347","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T19:22:47Z","timestamp":1538767367000},"page":"699-703","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Incidence and Treatment Outcomes of Vocal Fold Movement Impairment After Total Arch Replacement"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8291-4460","authenticated-orcid":false,"given":"Tanner","family":"Fullmer","sequence":"first","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt D.","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"LeMaire","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph S.","family":"Coselli","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Gregorio Casar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald T.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Eddie Liou","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julina","family":"Ongkasuwan","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.11.054"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.02.008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989010200207"},{"key":"e_1_2_6_5_1","unstructured":"ChenD PatroA PriceM et al.Inpatient vocal fold medialization for postoperative vocal fold movement impairment following thoracic aortic repair. Paper presented at the Triological Society Section Meeting. January 19\u201321 2017. 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