Journal of radiological science and technology (대한방사선기술학회지:방사선기술과학)

Korean Society of Radiological Science (대한방사선과학회)
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Finding Report of Unilateral Vocal Cord Paralysis Using Computed Tomography

컴퓨터단층촬영술을 이용한 수술 후 편측 성대마비의 진단보고

  • Kim, Minsoo (Department of Anesthesiology and Pain Medicine, School of Medicine, Kangwon National University & Hospital) ;
  • Seong, Hyun Ho (Department of Anesthesiology and Pain Medicine, School of Medicine, Kangwon National University & Hospital) ;
  • Kang, Seong Sik (Department of Anesthesiology and Pain Medicine, School of Medicine, Kangwon National University & Hospital) ;
  • Son, Hee Jeong (Department of Anesthesiology and Pain Medicine, School of Medicine, Kangwon National University & Hospital) ;
  • Kim, Tae-Hyung (Department of Radiological Science, College of Health Science, Kangwon National University) ;
  • Cheong, Yuseon (Department of Anesthesiology and Pain Medicine, School of Medicine, Kangwon National University & Hospital)
  • 김민수 (강원대학교병원 마취통증의학과, 강원대학교 의학전문대학원) ;
  • 성현호 (강원대학교병원 마취통증의학과, 강원대학교 의학전문대학원) ;
  • 강성식 (강원대학교병원 마취통증의학과, 강원대학교 의학전문대학원) ;
  • 손희정 (강원대학교병원 마취통증의학과, 강원대학교 의학전문대학원) ;
  • 김태형 (강원대학교 보건과학대학 방사선학과) ;
  • 정유선 (강원대학교병원 마취통증의학과, 강원대학교 의학전문대학원)
  • Received : 2018.10.09
  • Accepted : 2018.10.21
  • Published : 2018.10.31
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Abstract

VCP (Vocal Cord Paralysis) is rare but one of most serious complications related to endotracheal intubation. This report is a clinical experience of radiography and laryngeal EMG (Electromyography) assessment for the VCP. A 50-year-old woman with hoarseness, which was occurred after urethral diverticulum excision was examined by laryngoscopy. As a result of laryngoscopy, VCP was observed in left side of her vocal cord, and then recurrent laryngeal nerve damage was detected with additional CT (Computed tomography) scan and laryngeal EMG. After that, the vocal cord movement was recovered as normal state with regular conservative treatment for the 6 months.

Keywords

References

  1. Domino KB, Posner KL, Caplan RA, Cheney FW. Airway injury during anesthesia: a closed claims analysis. Anesthesiology. 1999;91(6):1703-11. https://doi.org/10.1097/00000542-199912000-00023
  2. Young VN, Smith LJ, Rosen C. Voice outcome following acute unilateral vocal fold paralysis. Ann Otol Rhinol Laryngol. 2013;122(3):197-204. https://doi.org/10.1177/000348941312200309
  3. Paquette CM, Manos DC, Psooy BJ. Unilateral vocal cord paralysis: a review of CT findings, mediastinal causes, and the course of the recurrent laryngeal nerves. Radiographics : a review publication of the Radiological Society of North America, Inc. 2012;32(3):721-40. https://doi.org/10.1148/rg.323115129
  4. Yumoto E, Minoda R, Hyodo M, Yamagata T. Causes of recurrent laryngeal nerve paralysis. Auris, nasus, larynx. 2002;29(1):41-5. https://doi.org/10.1016/S0385-8146(01)00122-5
  5. Tamura E, Tabata Y, Yamada C, Okada S, Iida M. Autologous fat augmentation of the vocal fold with basic fibroblast growth factor: Computed tomographic assessment of fat tissue survival after augmentation. Acta oto-laryngologica. 2015;135(11):1163-7. https://doi.org/10.3109/00016489.2015.1064544
  6. Mengsteab PY, Kwon JY, Han TR, Kwon TK, Kim DH, Kim SJ. Factors associated with the improvement of vocal fold movement: an analysis of LEMG and laryngeal CT parameters. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2015;25(1):1-7. https://doi.org/10.1016/j.jelekin.2014.08.004
  7. Hojjat H, Svider PF, Folbe AJ, Raza SN, Carron MA, Shkoukani MA, et al. Cost-effectiveness of routine computed tomography in the evaluation of idiopathic unilateral vocal fold paralysis. Laryngoscope. 2017;127(2):440-4. https://doi.org/10.1002/lary.26152
  8. Focquet A, Pereon Y, Segura S, Ferron C, Malard O, Espitalier F. Diagnostic and prognostic contribution of laryngeal electromyography in unilateral vocal-fold immobility in adults. Eur Ann Otorhinolaryngol Head Neck Dis. 2017;134(1):13-8. https://doi.org/10.1016/j.anorl.2016.09.006
  9. Munin MC, Heman-Ackah YD, Rosen CA, Sulica L, Maronian N, Mandel S, et al. Consensus statement: Using laryngeal electromyography for the diagnosis and treatment of vocal cord paralysis. Muscle & nerve. 2016;53(6):850-5. https://doi.org/10.1002/mus.25090
  10. Salem MR, Wong AY, Barangan VC, Canalis RF, Shaker MH, Lotter AM. Postoperative vocal cord paralysis in paediatric patients. Reports of cases and a review of possible aetiological factors. British journal of anaesthesia. 1971;43(7):696-700. https://doi.org/10.1093/bja/43.7.696
  11. Cavo JW, Jr. True vocal cord paralysis following intubation. Laryngoscope. 1985;95(11):1352-9. https://doi.org/10.1288/00005537-198511000-00012
  12. Shin YH, An DA, Choi WJ, Kim YH. Unilateral vocal cord paralysis following a short period of endotracheal intubation anesthesia. Korean Journal of Anesthesiology. 2013;65(4):357-8. https://doi.org/10.4097/kjae.2013.65.4.357
  13. Gómez JC, Melo LP, Orozco Y, Chicangana GA, Osorio DC. Estimation of the optimum length of endotracheal tube insertion in adults. Colombian Journal of Anesthesiology. 2016;44(3):228-34. https://doi.org/10.1016/j.rcae.2016.05.005
  14. Kikura M, Suzuki K, Itagaki T, Takada T, Sato S. Age and comorbidity as risk factors for vocal cord paralysis associated with tracheal intubation. British journal of anaesthesia. 2007;98(4):524-30. https://doi.org/10.1093/bja/aem005
  15. Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. British Medical Journal (Clinical research ed). 1984;288(6422):965-8. https://doi.org/10.1136/bmj.288.6422.965
  16. Wang CL, Tsai YH, Huang CC, Wu YK, Ye MZ, Chou HM, et al. The role of the cuff leak test in predicting the effects of corticosteroid treatment on postextubation stridor. Chang Gung Medical Journal. 2007;30:53-61.