3 years ago

Vocal cord paralysis after endotracheal intubation: an uncommon complication of general anesthesia

Claudia Hurtado Nazal, Andrea Araneda Vilches, Carolina Vergara Marín, Karen García Contreras, Carla Napolitano Valenzuela, Pedro Badía Ventí

Publication date: November–December 2018

Source: Brazilian Journal of Anesthesiology (English Edition), Volume 68, Issue 6

Author(s): Claudia Hurtado Nazal, Andrea Araneda Vilches, Carolina Vergara Marín, Karen García Contreras, Carla Napolitano Valenzuela, Pedro Badía Ventí

Abstract
Background

General anesthesia is a safe, frequent procedure in clinical practice. Although it is very unusual in procedures not related to head and or neck surgery, vocal cord paralysis is a serious and important complication. Incidence has been associated with patient age and comorbidities, as well as the position of the endotracheal tube and cuff. It can become a dangerous scenario because it predisposes aspiration.

Objectives

To present a case and analyze the risk factors associated with increased risk of vocal cord paralysis described in the literature.

Case report

53 year-old diabetic man, who developed hoarseness in the postoperative period after receiving general anesthesia for an elective abdominal laparoscopic surgery. Otolaryngological evaluation showed left vocal cord paralysis.

Conclusions

Vocal cord paralysis can be a serious complication of general anesthesia because of important voice dysfunction and risk of aspiration. The management is not yet fully established, so prevention and early diagnosis is essential.

Resumo
Justificativa

A anestesia geral é um procedimento seguro e frequente na prática clínica. Embora seja muito rara em procedimentos não relacionados à cirurgia de cabeça ou pescoço, a paralisia das cordas vocais é uma complicação séria e importante. Sua incidência tem sido associada à idade e comorbidades do paciente, bem como à posição do tubo endotraqueal e seu balonete. A paralisia das cordas vocais pode ser uma condição perigosa porque predispõe à aspiração.

Objetivos

Apresentar um caso e analisar os fatores de risco associados ao aumento do risco de paralisia das cordas vocais descritos na literatura.

Relato de caso

Paciente do sexo masculino, 53 anos, diabético, que desenvolveu rouquidão no pós-operatório após anestesia geral para cirurgia laparoscópica abdominal eletiva. A avaliação otorrinolaringológica mostrou paralisia da corda vocal esquerda.

Conclusões

A paralisia de cordas vocais pode ser uma complicação séria da anestesia geral devido ao risco grave de disfunção da voz e aspiração. O manejo dessa condição ainda não está totalmente estabelecido, de modo que a prevenção e o diagnóstico precoce são essenciais.

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