A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma
Akif Enes Arıkan1, Serkan Teksöz1, İsmail Ahmet Bilgin1, Özge Tarhan2, Ateş Özyeğin1
1Department of General Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
2Department of Ear, Nose and Throat, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
Keywords: Vocal cord hematoma, vocal cord paralysis, hematoma, thyroidectomy
Although vocal cord paralysis (VCP) following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis following thyroidectomy can be caused by a vocal cord hematoma with an incidence of 1.4% due to direct injury during orotracheal intubation. In this article, we present a case of VCP caused by vocal cord hematoma. A 32-year-old male patient who has been receiving propylthiouracil treatment for toxic multinodular goiter since 10 years was admitted to our hospital to be operated because of persisting complaints. The patient was hospitalized for sutureless thyroidectomy after he became euthyroid. Preoperative fiberoptic laryngoscopy performed by the ear, nose, and throat department revealed bilaterally motile vocal folds and a completely open airway. Patient underwent sutureless total thyroidectomy with a vessel sealing device (LigasureTM LF1212, Covidien, CO), and a minivac drainage system was placed in the thyroid lodge. On the morning of the first postoperative day, 50 mL of serosanguinous fluid was drained. The patient’s voice was normal, and there was no ecchymosis. Postoperative fiberoptic laryngoscopy revealed a hematoma near the right vocal fold and paralysis of the right vocal fold; however, the airway was open. It should be kept in mind that VCP is not solely due to surgery but can also result from intubation, as observed in this case.
Written informed consent was obtained from patient who participated in this case.
Concept - S.T., İ.A.B.; Design - A.E.A., S.T.; Supervision - S.T., A.Ö.; Funding - A.E.A., S.T., İ.A.B., Ö.T., A.Ö.; Materials - Ö.T., S.T., A.Ö.; Data Collection and/or Processing - A.E.A., S.T., İ.A.B., Ö.T., A.Ö.; Analysis and/or Interpretation - A.E.A., S.T., İ.A.B., Ö.T., A.Ö.; Literature Review - A.E.A., S.T.; Writer - A.E.A., S.T.; Critical Review - A.E.A., S.T.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.