ABSTRACT
Una de las complicaciones más importantes asociada la cirugía de tiroides y paratiroides es la parálisis de las cuerdas vocales secundaria a la lesión del nervio laríngeo recurrente. La parálisis del nervio laríngeo recurrente inducida por anestésicos locales es una rara complicación con muy pocos casos publicados.Las técnicas patrón para el examen de las cuerdas vocales son la fibrolaringoscopia flexible y la videoestrobolaringoscopia. Sin embargo, estas técnicas son caras, y frecuentemente se asocian con dolor y malestar para los pacientes. Considerando estas desventajas, la ecografía laríngea transcutánea es una alternativa en pacientes que se someten a cirugía de tiroides y paratiroides.Presentamos un caso en el que se diagnosticó ecográficamente una parálisis bilateral transitoria de las cuerdas vocales tras la infiltración local de 10mL de mepivacaína al 2% administrada para la revisión de la herida quirúrgica por un hematoma subcutáneo ocurrido después de una paratiroidectomía subtotal.(AU)
One of the most important complications associated with thyroid and parathyroid surgery is vocal cord paralysis due to a recurrent laryngeal nerve injury. Recurrent laryngeal nerve injury paralysis induced by local anesthetics is a rare complication with very few published casesVarious techniques are available for diagnosing vocal cord paralysis, including, flexible fiberoptic laryngoscopy, videostrobolaryngoscopy and indirect laryngoscopy. However, these techniques are expensive and are often associated with pain and discomfort among patients. Considering these disadvantages, transcutaneous laryngeal ultrasound is an alternative imaging tool for vocal cord examination in patients undergoing thyroid and parathyroid surgery.We describe a case which was sonographically diagnosed a transient bilateral vocal cord paralysis after the local infiltration of 10mL of 2% mepivacaine administered for the revision of the surgical wound due to a subcutaneous hematoma that occurred after a subtotal parathyroidectomy.(AU)
Subject(s)
Humans , Female , Middle Aged , Vocal Cord Paralysis , Anesthetics, Local , Recurrent Laryngeal Nerve Injuries , Vocal Cords/diagnostic imaging , Anesthesiology , Anesthesia/methods , Inpatients , Physical ExaminationABSTRACT
One of the most important complications associated with thyroid and parathyroid surgery is vocal cord paralysis due to a recurrent laryngeal nerve injury. Recurrent laryngeal nerve injury paralysis induced by local anesthetics is a rare complication with very few published cases Various techniques are available for diagnosing vocal cord paralysis, including, flexible fiberoptic laryngoscopy, videostrobolaryngoscopy and indirect laryngoscopy. However, these techniques are expensive and are often associated with pain and discomfort among patients. Considering these disadvantages, transcutaneous laryngeal ultrasound is an alternative imaging tool for vocal cord examination in patients undergoing thyroid and parathyroid surgery. We describe a case which was sonographically diagnosed a transient bilateral vocal cord paralysis after the local infiltration of 10mL of 2% mepivacaine administered for the revision of the surgical wound due to a subcutaneous hematoma that occurred after a subtotal parathyroidectomy.
