Korean J Crit Care Med.  1999 Jun;14(1):47-51.

Misconception of Bilateral Vocal Cord Paralysis as Laryngeal Spasm after Endotracheal Extubation

• Lee BJ
• Jeong JY
• Lee DI
• Kim DS

Abstract

We recently experienced an unexpected episode of bilateral vocal cord paralysis following endotracheal extubation after uvulopalatopharyngoplasty and tonsillectomy in 64-year-old man. The patient had no any other clinical manifestations regarding larynx or vocal cord except sleep apnea syndrome prior to this operation. The surgical procedure lasted almost 120 minutes and surgery and anesthesia was uneventful. After restoration of his spontaneous respiration, we tried extubation as usual method. Regardless his effort of spontaneous respiration for several times, he was suddenly apneic and showed declining of arterial oxygen saturation on the pulse oximeter (SpO2). Then we tried reintubation as a decision of laryngeal spasm. This alternative episode of extubation and reintubation was tried again and the causative factor of this respiratory impairment was confirmed as bilateral vocal cord paralysis by fiberoptic bronchoscopic examination in the operating room. Almost two thirds of vocal cord function was restored after six months of operation.

Keyword

Anesthesia; general; Complication; intubation; vocal cord paralysis

MeSH Terms

Airway Extubation*
Anesthesia
Humans
Intubation
Laryngismus*
Larynx
Middle Aged
Operating Rooms
Oxygen
Respiration
Sleep Apnea Syndromes
Tonsillectomy
Vocal Cord Paralysis*
Vocal Cords*
Oxygen