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    Alterações de laringe em crianças com cardiopatias congênitas
    (Universidade Federal de São Paulo (UNIFESP), 2015-09-30) Torres, Ana Amelia Soares [UNIFESP]; Pignatari, Shirley Shizue Nagata Pignatari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Congenital heart diseases (CHD) occurs in about 8-10 children per 1,000 live births, accounting for a large number of surgeries in the pediatric population. It is believed that these surgical procedures can cause laryngeal disorders, particularly vocal cord paralysis, and consequently postoperative complications; ventilation and extubation difficulties, and respiratory and subsequent phonation disorders. Several studies have shown that many children with CHD also present with associated laryngeal disturbs, which could contribute to postoperative complications. Due to the high frequency of surgeries for congenital heart diseases, it becomes important to find effective ways that help to prevent, minimize or treat such complications as early as possible. Objectives: Assess the occurrence of laryngeal diseases in patients with congenital heart disease and to determine whether the presence of these diseases is a critical postoperative complication outcome factor. Methods: A total of 52 pediatric patients undergoing cardiothoracic surgery at the Little Prince Hospital in Curitiba were evaluated. Patients underwent laryngoscopy with flexible laryngoscope (LF) to evaluate the characteristics of the upper airway before and after surgery. Information regarding demographic and clinical characteristics of the patients, as well as the outcome during hospitalization were collected. Data were statistically analyzed using Chi-square test or Fisher's exact test. Two-tailed t test was used to compare numeric variables. Results: Of 52 patients, Twenty-eight (53.8%) were female and 24 (46.2%) male (Figure 3). The median (percentil25-75%) age was 12 (5-60) months, a minimum of 0.4 months and a maximum of 264 months. Twenty-five percent of patients had some type of laryngeal affection. The diseases found were subglottic stenosis (n = 1) vallecula cyst (n = 1), intubation granuloma (n = 1), epidermoid cyst (n=1), laryngomalacia (n = 9). The occorrence of laryngeal diseases in our study were significantly higher (p <0.001), compared to the general population. No new laryngeal disorders were detected postoperatively, in addition to those initially observed preoperatively. There was no relationship between extubation difficulties and the laryngoscopy findings. Conclusions: The prevalence of laryngeal disorders in children with congenital heart disease is higher than in the general population. The surgical procedure may not be related to the increased frequency of laryngeal disorders, and laryngeal disorders do not seem to be a determinant factor for postoperative complications in these patients.