A Rare Case of Longstanding Complication Following a Total Thyroidectomy: An Incident Reporting

Vol 8 | Issue 1 | January-April 2022 | Page: 09-11 | Neha Panse, Poonam Ghodki, Musfarah An Um Anasuddin Farooqui

DOI: 10.13107/jaccr.2022.v08i01.194


Author: Neha Panse [1], Poonam Ghodki [1], Musfarah An Um Anasuddin Farooqui [1]

[1] Department of Anaesthesia, Smt. Kashibai Navale Medical College & General Hospital, Pune, Maharashtra, India.

Address of Correspondence
Dr. Musfarah An Um Anasuddin Farooqui
Department of Anaesthesia, Smt. Kashibai Navale Medical College & General Hospital, Pune, Maharashtra, India.
E-mail: musfarahanum11@gmail.com


Abstract
Introduction:
Vocal cord palsy after thyroid surgeries is a known complication. Most common cause is intraoperative iatrogenic injury to recurrent laryngeal nerve (RLN). Careful intraoperative dissection and identification of the complication in the immediate postoperative period can prevent grave consequences. Delayed presentation of vocal cord palsy is known but delay up to one month and patient surviving with symptoms for one year is extremely rare. Several theories have been postulated regarding survival.
Case report: We report a case of a middle aged female who first developed subcutaneous emphysema following thyroidectomy and then presented with recurrent complaints of dyspnoea and stridor for about a year, later diagnosed to have bilateral RLN injury, managed with tracheostomy twice and subsequently treated with laser cordectomy.
Conclusion: Tracheomalacia should be suspected in all long standing goitres. RLN palsy generally, an intraoperative complication should be assessed thoroughly in immediate post- operative period to improve the outcome of every thyroid surgery. Delayed palsies may be difficult to assess and diagnose and should be ruled out. Prevention is always better than cure: hence wherever possible an intraoperative nerve monitoring should be done.
Keywords: Recurrent laryngeal nerve, Subcutaneous emphysema, Thyroidectomy tracheostomy, Vocal cord palsy


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How to Cite this Article: Panse N, Ghodki P, Farooqui M | A Rare Case of Longstanding Complication Following a Total Thyroidectomy: An Incident Reporting | Journal of Anaesthesia and Critical Care Case Reports | January-April 2022; 8(1): 09-11.

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