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Revista Brasileira de Anestesiologia

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Abstract

MARANHAO, Marcius Vinícius M.  and  PINHO FILHO, Jorge. Paralysis of the left vocal cord secondary to left recurrent nerve lesion following surgery for ligation of the arterial canal: case report. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.4, pp. 453-456. ISSN 0034-7094.  http://dx.doi.org/10.1590/S0034-70942002000400009.

BACKGROUND AND OBJECTIVES: Postoperative dysphonia is commonly associated to tracheal intubation and extubation complications, but other causal factors may be involved, including surgical procedures. This article aimed at reporting a late postoperative dysphonia as a consequence of left vocal cord paralysis secondary to left recurrent laryngeal nerve injury during ductus arteriosus ligation procedure. CASE REPORT: Female patient, 6 years old, physical status ASA II, 18.8 kg, submitted to ductus arteriosus ligation. Patient was premedicated with oral midazolam (0.8 mg.kg-1) 60 minutes before surgery. Anesthesia was induced and maintained with sevoflurane, alfentanil and pancuronium. The ductus arteriosus was difficult to dissect. In the 4th postoperative day, patient presented with persistent dysphonia. Videolaryngoscopy has evidenced paralysis of the left vocal cord and a small paramedian gap. CONCLUSIONS: For its close relationship with the ductus arteriosus, the left recurrent laryngeal nerve may be damaged during corrective procedures, especially when there are difficulties in ductus arteriosus dissection and ligation. Unlike dysphonias resulting from complications of tracheal intubation and extubation, such dysphonias appear at a later stage, are long-lasting and may be even irreversible.

Keywords : COMPLICATIONS [recurrent laryngeal nerve injury]; COMPLICATIONS [vocal cord paralysis]; COMPLICATIONS [dysphonia]; SURGERY [Vascular]; SURGERY [ductus arteriosus persistency].

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