Vocal cord paralysis following orthognathic surgery intubation

Abstract

The incidence of recurrent laryngeal nerve paralysis following short-term oro-endotracheal intubation for any surgical procedure is very rare. The diagnosis becomes very difficult if the surgical procedure may alter the vocal characteristics following surgery. We report a case of a 24 year-old healthy male patient who developed prolonged hoarseness which developed after having undergone a bimaxillary orthognathic surgical procedure. Following surgery, the patient's complaints of hoarseness and mild coughing on taking thin liquids were investigated with the assistance of the otolarynology voice department. A flexible fiberoptic laryngoscopy and videostroboscopy showed a partial paralysis of the left vocal cord suggesting damage to the left recurrent laryngeal nerve. The recovery was gradual and resolved without any intervention in approximately 6 weeks. Prolonged change or loss of voice quality following an orthognathic surgical procedure, as discussed in this case, when associated with difficulty in swallowing thin or thick liquids warrants a thorough investigation and can be managed at times with observation alone.

Cuff depth and continuous chest auscultation method for determination of tracheal tube insertion depth in nasal intubation: observational study

“…Incorrect endotracheal placement of the tracheal tube can lead to serious complications, such as laryngeal nerve paralysis and accidental extubation [4]. To ensure that the cuff passes below the glottis, the Parker tube has a marker.…”

“…Therefore, it is necessary to determine accurately the positioning of the tracheal tube. Additionally, recurrent laryngeal nerve paralysis caused by the cuff of the tracheal tube has been reported [4]. Therefore, the position of the cuff should be such as to avoid excessive pressure on the cricoid cartilage.…”

Unilateral vocal cord paralysis following maxillofacial deformity correction

“…The incidence of VCP is very low [6]. Fauzdar et al [7] reported the only case of VCP after an orthognathic surgery. The change in the voice quality of the cases is thought to be caused by injury to the recurrent laryngeal nerve during EI.…”

Determination of tracheal tube insertion depth for dental procedure and oral and maxillofacial surgery

“…Incorrect endotracheal placement of the tracheal tube can lead to serious complications, such as laryngeal nerve paralysis and accidental extubation [1]. In oral and maxillofacial surgery and dental procedure, the head of the patient was covered in drape, and an anesthesiologist cannot often see tracheal tube.…”