| Vocal cord paralysis after open-heart surgery. | |
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MedLine Citation:
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PMID: 11932166 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Vocal cord paralysis is a known entity often described as a complication of neck surgery. A less frequent site of injury to the recurrent laryngeal nerve is the chest. The left side is usually more affected than the right side in view of its long intrathoracic segment. Only few cases of right vocal cord paralysis following open-heart surgery are reported in the literature. The purpose of this article is to review the common possible mechanisms of injury to the right recurrent laryngeal nerve following open-heart surgery in order to draw the attention of the caring physician to the clinical significance of such a complication. In fact, transient hoarseness following open-heart surgery may be an ominous sign of recurrent laryngeal nerve injury. It should not be assumed to be secondary to intralaryngeal edema. Several mechanisms of injury to the recurrent laryngeal nerve have been suggested: (1) through central venous catheterization; (2) by traction on the esophagus; (3) by direct vocal cord damage or palsy from a traumatic endotracheal intubation; (4) trauma by compression of the recurrent laryngeal nerve or its anterior branch at the tracheoesophageal groove by an inappropriately sized endotracheal tube cuff; (5) by a faulty insertion of a nasogastric tube; (6) median sternotomy and/or sternal traction pulling laterally on both subclavian arteries; (7) direct manipulation and retraction of the heart during open-heart procedures; (8) hypothermic injury with ice/slush. If vocal cord paralysis was overlooked as a possible complication of open-heart surgery, the patient may suffer from dysphonia in addition to problems of paramount importance such as inefficient cough and aspiration. Although it is true that the incidence of vocal cord paralysis remains very low, yet its presence is alarming and necessitates close follow up on the patient for the possible need of surgical intervention if recovery fails. |
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Authors:
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Abdel Latif Hamdan; Roger V Moukarbel; Firas Farhat; Mounir Obeid |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 21 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2002 Apr |
Date Detail:
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Created Date: 2002-04-04 Completed Date: 2002-06-28 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 671-4 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology -- Head and Neck Surgery, American University of Beirut, Beirut, Lebanon. hb03@aub.edu.lb |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Surgical Procedures
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adverse effects* Humans Incidence Laryngeal Nerves / injuries Postoperative Complications / diagnosis, epidemiology, etiology Vocal Cord Paralysis / diagnosis, epidemiology, etiology* |
| Comments/Corrections | |
Comment In:
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Eur J Cardiothorac Surg. 2003 Jan;23(1):137-8; author reply 138
[PMID:
12493529
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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