Two Cases of Bilateral Vocal Fold Mobility Impairment After LMA Use In 7 Months

Ann Otol Rhinol Laryngol. 2018 Sep;127(9):653-656. doi: 10.1177/0003489418784061. Epub 2018 Jul 26.

Abstract

Objectives: To increase awareness of vocal fold mobility impairment secondary to laryngeal mask airway (LMA) use in the operating room.

Methods: We report 2 cases of bilateral vocal fold mobility impairment after LMA use within 7 months of each other. One patient is a 52-year-old female who developed this complication after orthopedic elbow surgery. The second case is a 75-year-old male who presented after undergoing inguinal hernia repair.

Results: The patient from the first case required a 7-day hospital stay in the SICU due to airway compromise with spontaneous resolution of right-sided vocal fold immobility and improvement of symptoms. The 75-year-old male required direct laryngoscopy and bilateral true vocal fold injection medialization to correct his bilateral vocal fold paresis causing dysphonia and aspiration of liquids.

Conclusions: Bilateral vocal fold immobility secondary to LMA use is likely an underreported phenomenon of which otolaryngologists and anesthesiologists should be aware. Presentation may be severe, requiring hospitalization or operative intervention.

Keywords: laryngeal masks; recurrent laryngeal nerve; vocal fold paralysis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Female
  • Hoarseness / diagnosis
  • Hoarseness / etiology*
  • Hoarseness / physiopathology
  • Humans
  • Laryngeal Masks
  • Laryngoscopy / adverse effects*
  • Male
  • Middle Aged
  • Thyroidectomy / adverse effects*
  • Vocal Cord Paralysis / complications*
  • Vocal Cord Paralysis / diagnosis
  • Vocal Cord Paralysis / physiopathology
  • Vocal Cords / diagnostic imaging
  • Vocal Cords / injuries*
  • Vocal Cords / physiopathology