Determination of the incidence and severity of hoarseness after cardiac surgery

Background: The aim of the study was to determine the incidence and severity of hoarseness and vocal Cord dysfunction in 200 patients undergoing open heart surgery in Shiraz-Iran. Material/Methods: This study involved prospective evaluation of 200 patients who underwent open heart surgery during the year 200 in Shiraz University hospitals. All patients received the same standard anesthetic technique. In post-operative course, all patients were electively ventilated for variable periods depending on several factors, at least until the morning after surgery. All patients underwent direct laryngoscopy immediately after extubation by the otolaryngologist, and the existence and grade of hoarseness was evaluated on a four-point scale 6 and 12 hours after extubation. Results: Two hundred patients, 64.5% male and 35.5% female, with a mean age of 56.7 (S.D.=5.2) were evaluated. CABG was performed most frequently and the mean duration of cold perfusion was 122 minutes (S.D.=15). CVP insertion, endotracheal intubation, sternotomy, and hypothermia were performed in all patients. Hoarseness was found to be present in 17% of patients; all but one were rated to be grade one on the four-point scale. However, laryngoscopy did not reveal anything specific. Conclusions: The incidence of hoarseness in this study was 17%; similar series reported as high as 32%. Vocal cord dysfunction never occurred in our study and hoarseness probably resulted from intubation trauma. Although we found no case of nerve injury and cord dysfunction, vocal cord palsy as a rare cause of respiratory insufficiency in chest and neck surgeries must never be overlooked.