Open AccessManagement of bilateral recurrent laryngeal nerve paresis after thyroidectomy
Author(s) -
Anitha Sanapala,
M Nagaraju,
Lella Nageswara Rao,
Koteswar Nalluri
Publication year - 2015
Publication title -
al-banǧ. maqālāt wa abḥāṯ fī al-taẖdīr wa-al-in’āš
Language(s) - English
Resource type - Journals
ISSN - 0259-1162
DOI - 10.4103/0259-1162.152419
Subject(s) - medicine , stridor , recurrent laryngeal nerve , paresis , surgery , thyroidectomy , phonation , anesthesia , respiratory distress , laryngoscopy , thyroid , pharyngeal reflex , airway , intubation , audiology
Bilateral recurrent laryngeal nerve (RLN) injury is rare for benign thyroid lesions (0.2%). After extubation-stridor, respiratory distress, aphonia occurs due to the closure of the glottic aperture necessitating immediate intervention and emergency intubation or tracheostomy. Intra-operative identification and preservation of the RLN minimizes the risk of injury. It is customary to expect RLN problems after thyroid surgery especially if malignancy, big thyroid, distorted anatomical problems and difficult airway that can lead to intubation trauma. Soon after extubating, it is essential to the anesthetist to check the vocal cord movements on phonation and oropharyngeal reflexes competency. But this case is specially mentioned to convey the message that in spite of absence of above mentioned predisposing factors for complications and good recovery profile specific to thyroid, there can be unanticipated airway compromise that if not attended to immediately may cost patient's life. This is a case of postextubation stridor following subtotal thyroidectomy due to bilateral RLN damage and its management.