• Anna Miles, Naomi McLellan, Rochelle Machan, David Vokes, Alexandra Hunting, Mary McFarlane, Jennifer Holmes, and Kelly Lynn.
• The University of Auckland, Tamaki Campus, Morrin Rd, New Zealand. Electronic address: a.miles@auckland.ac.nz.
• J Crit Care. 2018 Jun 1; 45: 121-127.

PurposeCardiothoracic surgery is known to result in dysphagia and laryngeal injury. While prevalence has been explored, extent, trajectory and longevity of symptoms are poorly understood. This retrospective, observational study explored dysphagia and laryngeal injury in patients following cardiothoracic surgery referred for instrumental swallowing assessment.MethodsClinical notes and endoscopic recordings of 106 patients (age range 18-87yrs; mean 63yrs; SD 15yrs) (including 190 endoscopes) at one large tertiary centre were reviewed by two speech-language pathologists and a laryngologist. Standardized measures of laryngeal anatomy and physiology, New Zealand Secretion Scale, Penetration-Aspiration scale and Yale Residue Scale were rated.ResultsPrevalence of abnormality included 39% silent aspiration, 65% laryngeal edema and 61% vocal paralysis. The incidence of pneumonia was 36% with a post-operative stroke rate of 14%. Forty percent of patients were receiving a standard diet by discharge from acute care; while, 24% continued to require enteral feeding and 8% received laryngeal surgery within twelve months of discharge. Vocal fold motion impairment was significantly associated with ventilation time and tracheostomy tube duration (p<.05).ConclusionEarly endoscopic assessment for identification of dysphagia and laryngeal injury in patients following cardiothoracic surgery may allow early management and prevention of secondary complications.Copyright © 2018 Elsevier Inc. All rights reserved.

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