Korean J Anesthesiol.  2012 Apr;62(4):387-390. 10.4097/kjae.2012.62.4.387.

Acute pulmonary edema secondary to upper airway obstruction by bilateral vocal cord paralysis after total thyroidectomy: A case report

• Kim WH
• Ryu SA

• KMID: 2238039
• DOI: http://doi.org/10.4097/kjae.2012.62.4.387

Abstract

This paper reports the case of a 65-year-old woman with a history of mild arterial hypertension who presented with acute pulmonary edema immediately after a total thyroidectomy. The edema was found to have been caused by an acute upper airway obstruction secondary to bilateral vocal cord paralysis. Her pulmonary edema resolved with treatment including reintubation, mechanical ventilation with positive end-expiratory pressure, diuretics, morphine, and fluid restriction. This report discusses the possible pathogenesis of this rare clinical situation. This case highlights the possibility of an acute upper airway obstruction caused by bilateral vocal cord paralysis after a total thyroidectomy and the need for prompt treatment to prevent the development of pulmonary edema.

Keyword

Acute upper airway obstruction; Pulmonary edema; Recurrent laryngeal nerve injury; Thyroidectomy; Vocal cord paralysis

MeSH Terms

Aged
Airway Obstruction
Diuretics
Edema
Female
Humans
Hypertension
Morphine
Positive-Pressure Respiration
Pulmonary Edema
Recurrent Laryngeal Nerve Injuries
Respiration, Artificial
Thyroidectomy
Vocal Cord Paralysis
Vocal Cords
Diuretics
Morphine