RESUMO
Bilateral vocal cord paralysis may occur as a result of mechanical injury during neck surgery, nerve compression by endotracheal intubation or mass, trauma, and neuromuscular diseases. However, only a few cases of bilateral vocal cord paralysis have occurred following short-term endotracheal intubation. We report a case of bilateral vocal cord paralysis subsequent to extubation after endotracheal intubation and mechanical ventilation due to severe pneumonia for 2 days.
Assuntos
Intubação Intratraqueal , Pescoço , Doenças Neuromusculares , Pneumonia , Respiração Artificial , Paralisia das Pregas Vocais , Prega VocalRESUMO
Vocal cord paralysis is one of the most serious anesthetic complications related to endotracheal intubation. The practitioner should take extreme care, as bilateral vocal cord paralysis can obstruct the airway and lead to disastrous respiratory problems. There have been many papers on bilateral vocal cord paralysis after neck surgery, but reports on such a condition after lung surgery are very rare. We report a case of bilateral vocal cord paralysis detected after removal of a double-lumen endotracheal tube in a 67-year-old patient who underwent wedge resection by video-assisted thoracoscopic surgery. We also note that he recovered spontaneously without complications within a day.
Assuntos
Idoso , Humanos , Intubação Intratraqueal , Pulmão , Pescoço , Cirurgia Torácica Vídeoassistida , Paralisia das Pregas Vocais , Prega VocalRESUMO
Bilateral vocal cord paralysis generally arises from trauma, tumor compression of the recurrent laryngeal nerves, surgery on neck and neurological diseases. Progressive supranuclear palsy is a rare degenerative disease showing supranuclear ophthalnoplegia, rigidity, bradykinesia, dysarthria and dementia. Bilateral vocal cord paralysis in patients with progressive supranuclear palsy can be found only in a few cases reported in literature. The finding of bilateral vocal cord paralysis is important because it can be life threatening. We managed a patient with the laterofixation of vocal cord for preventing respiratory failure due to glottic airway compromise. We report this case with a review of literature.
Assuntos
Humanos , Demência , Disartria , Hipocinesia , Pescoço , Nervo Laríngeo Recorrente , Insuficiência Respiratória , Paralisia Supranuclear Progressiva , Paralisia das Pregas Vocais , Prega VocalRESUMO
We had a case of respiratory difficulty following tracheal extubation due to bilateral vocal cord paralysis. The patient was a 66-year-old woman undergoing craniotomy for cerebellopontine angle meningioma. Anesthesia was uneventful. Spontaneous respiration resumed after reversal of neuromuscular blockade. Following extubation she showed inspiratory stridor, tachypnea, and chest retraction. Reintubation was done and then tracheostomy was performed. Every factor contributing vocal cord paralysis such as pressure on the nerve by an overexpanded endotracheal tube cuff, unique posture of the neck during the operation, and female gender, long operating time(about 11 hours) were seemed to be possible causes and we considered the interaction of these combinations responsible for the bilateral vocal cord paralysis. Eight weeks later, the patient's vocal cord function had returned to normal.