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We reviewed the records of 167 neonates and older children undergoing ligation of a patent ductus arteriosus to determine the prevalence of recurrent laryngeal nerve injury and identify risk factors that might increase the likelihood of injury. Paralysis or paresis of the left vocal cord was identified by fiberoptic laryngoscopy in seven patients. All seven weighted less than 1500 gm at the time of operation and the ductus had been ligated with a metal clip. All had persistent symptoms when observed for 5 to 19 months. Injury to the left recurrent laryngeal nerve occurs infrequently but may have long-term consequences.
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