Background: The clinical characteristics and outcomes of hoarseness subsequent to cardiovascular
surgery, intervention, maneuver and endotracheal intubation have not been systematically
elucidated.
Methods: The literature of hoarseness following cardiovascular surgery, intervention, and
maneuver and intubation published between 1980 and 2011 was comprehensively retrieved in
the MEDLINE database and the Google and Highwire Press search engines.
Results: The so-called “iatrogenic Ortner’s (cardiovocal) syndrome” developed 0–7 (2.33 ±
± 2.66) days following cardiovascular surgery, intervention, maneuver and endotracheal
intubation with an incidence of 10.15%. The most common symptoms associated with
hoarseness were stridor (49.45%) and aspiration (15.38%). Patent ductus arteriosus ligation
and otherwise congenital heart disease repair were the two main causes leading to such
a complication. Patients’ hoarse voice spontaneously resolved in 70.52%, and persisted in
33.61% of the patients. Treatment of the hoarseness included gelfoam/teflon injection,
intravenous steroid therapy, type 1 thyroplasty and arytenoid adduction. Hoarseness recovered
in 46.67%, improved in 13.33%, and persisted in 40%.
Conclusions: The recurrent laryngeal nerve was often injured following cardiovascular
surgery, intervention, maneuver and endotracheal intubation. Care must be taken during the
manipulations in order to avoid the nerve injury. The so-called “iatrogenic Ortner’s
(cardiovocal) syndrome” was a wrong concept as it did not meet the satisfaction of a main
element cardiovascular disease as an underlying cause of hoarseness of the definition of
Ortner’s (cardiovocal) syndrome defined by Ortner in 1897. It was actually an immediate
vocal cord complication following cardiovascular manipulation