Prevalence and resource utilization for vocal fold paralysis/paresis after esophagectomy.

Journal Article


Vocal fold paralysis/paresis (VFP) is an uncommon but serious complication following esophagectomy. The objectives of this study were to: 1) identify the prevalence of VFP and associated complications after esophagectomy in the United States, and 2) determine the utilization and otolaryngology-head and neck surgery/speech-language pathology (OHNS/SLP) and predictors of such utilization in the management of these patients.

Study design

Retrospective database analysis.


The National Inpatient Sample (NIS) represents a 20% stratified sample of discharges from US hospitals. Using International Classification of Diseases, Ninth Revision, Clinical Modification codes, patients undergoing esophagectomy between 2008 and 2013 were identified in the NIS. Subcohorts of patients with VFP and OHNS/SLP utilization were also identified. Weighted logistic regression models were used to compare binary outcomes such as complications; generalized linear models were used to compare total hospital charges and length of stay (LOS).


We studied 10,896 discharges, representing a weighted estimate of 52,610 patients undergoing esophagectomy. The incidence of VFP after esophagectomy was 1.96%. Compared to those without VFP, patients with VFP had a higher incidence of postoperative pneumonia, more medical complications, and were more likely to undergo tracheostomy; hospital charges and LOS were also higher. Of the patients with VFP, 35.0% received OHNS/SLP intervention.


VFP after esophagectomy is associated with postoperative complications, prolonged LOS, and higher hospital costs. OHNS/SLP intervention occurred in roughly one-third of postesophagectomy VFP patients, suggesting there may be opportunities for enhanced evaluation and management of these patients.

Level of evidence

4 Laryngoscope, 128:2815-2822, 2018.

Full Text

Duke Authors

Cited Authors

  • Crowson, MG; Tong, BC; Lee, H-J; Song, Y; Harpole, DH; Jones, HN; Cohen, S

Published Date

  • December 2018

Published In

Volume / Issue

  • 128 / 12

Start / End Page

  • 2815 - 2822

PubMed ID

  • 30229921

Pubmed Central ID

  • 30229921

Electronic International Standard Serial Number (EISSN)

  • 1531-4995

International Standard Serial Number (ISSN)

  • 0023-852X

Digital Object Identifier (DOI)

  • 10.1002/lary.27252


  • eng