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AIRWAY MANAGEMENT IN A PATIENT WITH ACUTE BILATERAL VOCAL CORD PARALYSIS
LADA MARIJAN
; Sveti Duh University Hospital, Integrated Emergency Reception, Zagreb, Croatia
VIŠNJA NESEK ADAM
; Sveti Duh University Hospital, Integrated Emergency Reception, Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb and Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
TINO KLANCIR
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb, Croatia
Abstract
Bilateral vocal cord paralysis is a rare, life-threatening clinical condition with possibly lethal outcome if airway is not treated immediately. The most common causes of bilateral vocal cord paralysis are previous head and neck surgeries, endotracheal intubation, neurological causes, and laryngeal carcinomas. Clinical presentation includes change of voice quality and hoarseness as the fi rst symptom, with slow progression into stridor and acute respiratory insuffi ciency. This case report describes an elderly female patient admitted to our emergency unit in unconscious, tachydyspneic, cyanotic, hypotensive condition, with weak arterial pulse. Physical examination included urgent fi beroptic examination, with vocal cord midline fi xation seen. According to this fi nding, urgent conicotomy was performed, and later, when the patient was stable, tracheotomy as permanent airway management was performed in the operating room. Soon upon the airway management, the patient regained consciousness and respiratory suffi ciency.
Keywords
vocal cord paralysis; acute respiratory insuffi ciency; conicotomy; tracheotomy
Hrčak ID:
209074
URI
Publication date:
18.11.2018.
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