Professional paper

Late manifestation of bilateral laryngeal nerve palsy after thyroidectomy

TOBIAS SCHULZE ; Department of Surgery, University of Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
CLAUS-DIETER HEIDECKE ; Department of Surgery, University of Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
STEFAN MAIER ; Department of Surgery, University of Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
STEPHAN KNIGGE ; Department of Anesthesiology, University of Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany

Abstract

Respiratory distress is a feared complication after thyroid surgery. Differential diagnosis includes bilateral recurrent laryngeal nerve palsy (BRLNP), local hematoma, vocal cord edema and laryngeal trauma. BRLNP results from intraoperative irritation without physical injury (neurapraxia), or intraoperative partial or complete transsection (axonotmesis and neurotmesis, respectively) of the recurrent laryngeal nerve (RLN). RLN palsy typically manifests immediately in the postoperative course. However, in rare cases there is a delayed, progressive development of BRLNP, potentially leading to respiratory failure in emergency setting weeks after initial surgery. Herein we report on a patient developing massive respiratory distress secondary to BRLNP 5 weeks after thyroidectomy for massive goiter. With the current tendency to decrease the length of hospital stay after thyroid surgery, late onset palsy of the RLN should be included into the differential diagnosis for acute respiratory distress in patients with recent history of thyroid surgery.

Keywords

bilateral recurrent laryngeal nerve palsy; respiratory distress; thyroidectomy; goiter; postoperative complication

Hrčak ID:

110342

URI

https://hrcak.srce.hr/110342

Publication date:

1.10.2013.

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