{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:07:47Z","timestamp":1787764067723,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,2,10]],"date-time":"2014-02-10T00:00:00Z","timestamp":1391990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the incidence of vocal cord (VC) paralysis and dysphagia after aortic arch reconstruction, including the Norwood procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary children's hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Database\/chart review of neonates requiring Norwood or arch surgery between January 2005 and December 2012. Demographics, postoperative VC function, dysphagia, need for gastrostomy tube and\/or tracheotomy, and long\u2010term follow\u2010up were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred fifty\u2010one consecutive subjects (96\u00a0Norwood, 55 aortic arch) were reviewed. Median age at repair was 9\u00a0days (interquartile range [IQR], 7\u201013) for Norwood and 24\u00a0days (IQR, 12\u201049) for arch reconstruction (<jats:italic>P<\/jats:italic> &lt;. 001). Documentation of VC motion abnormality was found in 60 of 104 (57.6%) subjects and unavailable in 47 (16 without documentation and 31 who died prior to extubation). There were no significant differences in proportions of documented VC motion (<jats:italic>P<\/jats:italic> =. 337), dysphagia (<jats:italic>P<\/jats:italic> =. 987), and VC paralysis (<jats:italic>P<\/jats:italic> =. 706) between the arch and Norwood groups. Dysphagia was found in 73.5% of Norwood and 69.2% of arch subjects who had documented VC paralysis. Even without unilateral VC paralysis (UVCP), dysphagia was present (56% Norwood, 61% arch). Overall, 120 of 151 (79.5%) required feeding evaluation and a modified feeding regimen. Gastrostomy was required in 31% of Norwood and 23.6% of arch reconstruction overall. To date, mortality in this series is 55 of 151 (36.4%) patients. Of those with VC paralysis, only 23 (22%) had any otolaryngology follow\u2010up after discharge from surgery. More than 75% with VC paralysis with follow\u2010up after hospital discharge had persistent VC paralysis 11.5\u00a0months after diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is high incidence of UVCP and dysphagia after Norwood and arch reconstruction. Dysphagia was highly prevalent in both groups even without UVCP. Preoperative discussion on vocal cord function and dysphagia should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599814522413","type":"journal-article","created":{"date-parts":[[2014,2,10]],"date-time":"2014-02-10T20:41:30Z","timestamp":1392064890000},"page":"827-833","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Vocal Cord Paralysis and Dysphagia after Aortic Arch Reconstruction and Norwood Procedure"],"prefix":"10.1002","volume":"150","author":[{"given":"Vinh","family":"Pham","sequence":"first","affiliation":[{"name":"University of Kansas School of Medicine Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Children's Mercy Hospitals &amp; Clinics Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L.","family":"Wei","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Nemours Children's Hospital University of Central Florida School of Medicine Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Sykes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head Neck Surgery University of Kansas Medical Center Kansa City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Children's Mercy Hospitals &amp; Clinics Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.4.336"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000099226"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.1.21"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2005.07.013"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-007-9027-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2009.00323.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2007.01.007"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200304000-00004"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000154745.78808.02"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199906000-00026"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3283590b56"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-005-0002-4"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.109"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.06.027"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.07.028"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.01.009"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00956-1"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(03)00173-7"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2009.124"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0385-8146(02)00114-1"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.24"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.84"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.520"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-3653"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2012.09.011"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599814522413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599814522413","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599814522413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:17:06Z","timestamp":1760962626000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599814522413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,10]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,5]]}},"alternative-id":["10.1177\/0194599814522413"],"URL":"https:\/\/doi.org\/10.1177\/0194599814522413","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,10]]},"assertion":[{"value":"2013-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-01-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-02-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}