Total tiroidektomi sonrası geçici iki taraflı vokal kord felci

Vokal kord felci, tiroidektominin ciddi bir komplikasyonu olmakla birlikte sağlık hizmeti sunucuları için endişe vericidir ve potansiyel olarak hasta ve ailesi için felaket olabilir. Elli altı yaşında bir kadın hasta sıkıştırıcı semptomları olan geniş bir guatr için rutin tiroidektomi ve boyun diseksiyonundan hemen sonra iki taraflı vokal kord felci ile başvurdu. Hasta vokal kord hareketinin tamamen iyileşmesi ile ertesi gün ekstübe edildi. Bu yazıda vokal kord felci nedenleri için cerrahi, metabolik ve anestetik faktörler dahil olmak üzere olası açıklamalar tartışıldı

Transient bilateral vocal fold paralysis after total thyroidectomy

Vocal fold paralysis is a serious complication of thyroidectomy that is worrisome for health providers and potentially disastrous for the patient and family. A 56-year-old woman presented with bilateral vocal fold paralysis immediately after routine thyroidectomy and neck dissection for a large goiter with compressive symptoms. She was extubated the next day with full recovery of vocal fold motion. We discuss possible causes of vocal fold paralysis, including surgical, metabolic and anesthetic factors.

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  • Lo CY, Kwok KF, Yuen PW. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Arch Surg 2000;135:204-7.
  • Kikura M, Suzuki K, Itagaki T, Takada T, Sato S. Age and comorbidity as risk factors for vocal cord paralysis associated with tracheal intubation. Br J Anaesth 2007;98:524-30.
  • Tomar GS, Kumar N, Saxena A, Goyal K. Head injury patient with bilateral vocal cord paralysis: a mistake and a lesson learnt. BMJ Case Rep 2015.
  • Casella C, Pata G, Nascimbeni R, Mittempergher F, Salerni B. Does extralaryngeal branching have an impact on the rate of postoperative transient or permanent recurrent laryngeal nerve palsy? World J Surg 2009;33:261-5.
  • Sancho JJ, Pascual-Damieta M, Pereira JA, Carrera MJ, Fontané J, Sitges-Serra A. Risk factors for transient vocal cord palsy after thyroidectomy. Br J Surg 2008;95:961-7.
  • Büyükcam F, Sönmez FT, Sahinli H. A delayed diagnosis: stridor secondary to hypocalcemia. Int J Emerg Med 2010;3:461-2.
  • Ellis PD, Pallister WK. Recurrent laryngeal nerve palsy and endotracheal intubation. J Laryngol Otol 1975;89:823-6.
  • Jeong DM, Kim GH, Kim JA, Lee SM. Transient bilateral vocal cord paralysis after endotracheal intubation with double-lumen tube -A case report-. Korean J Anesthesiol 2010;59:9-12.
  • Cavo JW Jr. True vocal cord paralysis following intubation. Laryngoscope 1985;95:1352-9.
  • Inomata S, Nishikawa T, Suga A, Yamashita S. Transient bilateral vocal cord paralysis after insertion of a laryngeal mask airway. Anesthesiology 1995;82:787-8.
  • Lumb AB, Wrigley MW. The effect of nitrous oxide on laryngeal mask cuff pressure. In vitro and in vivo studies. Anaesthesia 1992;47:320-3.
  • Wason R, Gupta P, Gogia AR. Bilateral adductor vocal cord paresis following endotracheal intubation for general anaesthesia. Anaesth Intensive Care 2004;32:417-8.
  • Nuutinen J, Kärjä J. Bilateral vocal cord paralysis following general anesthesia. Laryngoscope 1981;91:83-6.
  • Tekin M, Acar GO, Kaytaz A, Savrun FK, Çelik M, Cam OH. Bilateral vocal cord paralysis secondary to head and neck surgery. J Craniofac Surg 2012;23:135-7.