Bilateral vocal cord palsy post thyroidectomy: lessons learnt

Misron, Khairunnisak; Balasubramanian, Anusha; Mohamad, Irfan; Hassan, Nazirah

doi:10.1136/bcr-2013-201033

Cited by 13 publications

(11 citation statements)

References 8 publications

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“…The incidence of recurrent laryngeal nerve palsy after thyroidectomy is in the range of 3.5-6.6%; out of this the incidence of bilateral vocal cord paralysis is as low as 0.58%. 7 A study has shown that 1.3 % of the patients who are scheduled for thyroidectomy can suffer preoperative vocal cord palsy, out of which 76% will have a malignant pathology. 8 Thus, there was a high possibility for recurrent tumour infiltration contributing to vocal cord palsy in this patient.…”

Section: Discussionmentioning

confidence: 99%

A ‘can’t intubate, can’t oxygenate’ situation during an elective redo thyroid surgery; successful rescue and the lessons learnt

Jayaweera¹,

Abayadeera²,

DASSANAYAKE³

2022

Anaesth. pain intensive care

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Pre-operative assessment of a patient for routine redo thyroidectomy requires a detailed airway assessment, clear documentation and formulation of an appropriate airway management plan by the anesthetist. Failure to identify problems related to oxygenation and ventilation during surgery will cause grave consequences to the patient and an unpleasant experience to the anesthetist and the surgeon. Redo thyroid surgery can be challenging. There is a possibility of preoperative vocal cord palsy due to previous surgical insult and infiltration by tumour recurrence, that can lead to difficulty in ventilation following induction of anesthesia. Therefore, it is mandatory to perform a detailed assessment of the airway using conventional as well as the advanced techniques. We report the lessons learnt from a 42-year-old, ASA I, male patient scheduled for a redo thyroidectomy who could not be intubated nor ventilated, following a “missed difficult airway,” despite a clean history and the available past records. An emergency airway was declared and managed according to Difficult Airway Society (DAS) guidelines which finally resulted in a successful outcome. Subsequent evaluation by the ENT team revealed an absent glottic opening due to bilateral vocal cord palsy which resulted in a “can’t intubate, can’t oxygenate” state in this patient. Citation: Jayaweer DA, Abayadeera A, Dassanayake V. ‘Can’t intubate, can’t oxygenate’ during an elective redo thyroid surgery; A successful rescue and the lesson learnt. Anaesth. pain intensive care 2022;26(5):727-729. DOI: 10.35975/apic.v26i5.1984

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Section: Discussionmentioning

confidence: 99%

A ‘can’t intubate, can’t oxygenate’ situation during an elective redo thyroid surgery; successful rescue and the lessons learnt

Jayaweera¹,

Abayadeera²,

DASSANAYAKE³

2022

Anaesth. pain intensive care

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“…3 Literature shows that patients with transient vocal cord paralysis may show recovery as early as 3 days to 3 months. 5 This patient in this case was taught proper vocal technique and swallowing manoeuvres with aid of speech therapist. He showed recovery in two months duration with resolved of aspiration symptoms and hoarseness of voice.…”

Section: Discussionmentioning

confidence: 99%

Bilateral vocal cord paresis as a rare complication of endoscopic retrograde cholangiopancreatography: a case report for the attention of endoscopist

Paniselvam

Nordin

2019

Int J Otorhinolaryngol Head Neck Surg

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<p class="abstract">Bilateral vocal cord paresis is an extremely rare complication of endoscopic retrograde cholangiopancreatography (ERCP) with no case reported prior to this. We present a case of a 38 years old gentleman who suddenly developed aphonia and aspiration symptoms following ERCP. A rigid laryngoscopy done showed adductor paresis of bilateral vocal cords causing his symptoms, which was presumed to be a complication of the ERCP. He was treated conservatively and clinically improved with time. The present case report emphasizes that bilateral vocal cord paresis could occur as a complication of ERCP.</p>

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“…BVCPATT was quite rare, with an incidence rate of about 0.80% in this study. Bilateral vocal cord palsy (BVCP) may result from various causes, including endotracheal intubation [7] , laryngeal mask [8] , unidentified causes [9] , use of IONM [10] , and thyroid surgery itself [11] , [12] . In almost half the patients with dyspnea as the main symptom of BVCP, temporary tracheotomy or surgical glottis widening procedures had to be performed [13] .…”

Section: Discussionmentioning

confidence: 99%

Bilateral vocal cord palsy after total thyroidectomy–A new treatment–Case reports

Chou

Hsu

Lai

et al. 2017

International Journal of Surgery Case Reports

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Bilateral vocal cord palsy post thyroidectomy: lessons learnt

Cited by 13 publications

References 8 publications

A ‘can’t intubate, can’t oxygenate’ situation during an elective redo thyroid surgery; successful rescue and the lessons learnt

A ‘can’t intubate, can’t oxygenate’ situation during an elective redo thyroid surgery; successful rescue and the lessons learnt

Bilateral vocal cord paresis as a rare complication of endoscopic retrograde cholangiopancreatography: a case report for the attention of endoscopist

Bilateral vocal cord palsy after total thyroidectomy–A new treatment–Case reports

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