{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:15:24Z","timestamp":1770142524594,"version":"3.49.0"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"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":[[2023,12]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Children undergoing cervical and\/or thoracic operations are at risk for recurrent laryngeal nerve injury, resulting in vocal fold movement impairment (VFMI). Screening for VFMI is often reserved for symptomatic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Identify the prevalence of VFMI in screened preoperative patients prior to an at\u2010risk operation to evaluate the value of screening all patients at\u2010risk for VFMI, regardless of symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single center, retrospective review of all patients undergoing a preoperative flexible nasolaryngoscopy between 2017 and 2021, examining the presence of VFMI and associated symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated 297 patients with a median (IQR) age of 18 (7.8, 56.3) months and a weight of 11.3 (7.8, 17.7) kilograms. Most had a history of esophageal atresia (EA, 60%), and a prior at\u2010risk cervical or thoracic operation (73%). Overall, 72 (24%) patients presented with VFMI (51% left, 26% right, and 22% bilateral). Of patients with VFMI, 47% did not exhibit the classic symptoms (stridor, dysphonia, and aspiration) of VFMI. Dysphonia was the most prevalent classic VFMI symptom, yet only present in 18 (25%) patients. Patients presenting with a history of at\u2010risk surgery (OR 2.3, 95%CI 1.1, 4.8, <jats:italic>p<\/jats:italic>\u00a0=\u20090.03), presence of a tracheostomy (OR 3.1, 95%CI 1.0, 10.0, <jats:italic>p<\/jats:italic>\u00a0=\u20090.04), or presence of a surgical feeding tube (OR 3.1, 95%CI 1.6, 6.2, <jats:italic>p<\/jats:italic>\u00a0=\u20090.001) were more likely to present with VFMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Routine screening for VFMI should be considered in all at\u2010risk patients, regardless of symptoms or prior operations, particularly in those with a history of an at\u2010risk surgery, presence of tracheostomy, or a surgical feeding tube.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 133:3564\u20133570, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30646","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T11:24:33Z","timestamp":1678361073000},"page":"3564-3570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Screening for Vocal Fold Movement Impairment in Children Undergoing Esophageal and Airway Surgery"],"prefix":"10.1002","volume":"133","author":[{"given":"Jay W.","family":"Meisner","sequence":"first","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8286-4739","authenticated-orcid":false,"given":"Shawn","family":"Izadi","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Kamran","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hester F.","family":"Shieh","sequence":"additional","affiliation":[{"name":"Department of Surgery Johns Hopkins All Childrens  St Petersburg Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Jason","family":"Smithers","sequence":"additional","affiliation":[{"name":"Department of Surgery Johns Hopkins All Childrens  St Petersburg Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farokh R.","family":"Demehri","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somala","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0636-6233","authenticated-orcid":false,"given":"Claire","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery Children's National  Washington District of Columbia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5448-1546","authenticated-orcid":false,"given":"Sukgi S.","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Zendejas","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital  Boston Massachusetts 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