Funding outcome

Unilateral vocal fold immobility (UVFI) is the inability or loss of vocal fold motion and is a complication that often results from certain types of surgery on the heart, airway, and esophagus. This happens because the recurrent laryngeal nerve (RLN), which is a nerve that controls vocal fold movement, runs close to many of these important structures. If this nerve is damaged during surgery, it can affect vocal fold movement. UVFI can impair breathing, swallowing, and voice function, which may significantly impact the quality of life of children. Since these types of operations are done more often or exclusively in children, and because of the smaller size of these structures, children are at a higher risk for VFI than adults. Despite this increased risk, there are limited reports of techniques to reduce UVFI rates in children. Nerve monitors can be used during surgery to check if a nerve is being stretched or damaged during an operation. These monitors have been used in adults for certain surgeries but have not been regularly documented or used in children due to a lack of availability of small nerve monitors. A new device has now been approved that can be used on infants and children. The potential to decrease nerve damage by using these monitors would be very impactful, and there is minimal risk to a patient by adding this nerve monitor to these operations. There have not been any studies that directly compared how often VFI occurs in children that do have nerve monitoring versus those that do not, which represents an important gap in surgical care for children. The goal of this study is to test if the nerve monitoring technique helps prevent UVFI in children who are having high risk surgeries. We also hope to learn if there are certain factors that affect the severity of UVFI symptoms and track how many patients recover on their own or need further treatments. This research will help guide safer surgical practices and improve outcomes for children.