Paradoxical vocal cord motion in the recovery room: a masquerader of pulmonary dysfunction

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
G A Arndt, B R Voth

Abstract

We report a case of paradoxical vocal cord motion as an unusual cause of postoperative stridor and wheezing. A means of diagnosis and management is discussed. A 71-yr-old man developed paradoxical vocal cord motion following uncomplicated hip replacement. He was treated with standard therapy for postoperative stridor and wheezing. After extensive evaluation, a flexible fibreoptic laryngoscope was used and the vocal cords noted to move paradoxically. This was the cause of his postoperative stridor and wheezing. Paradoxical vocal cord motion should be suspected as a cause of postoperative stridor and wheezing when the airway is easily maintained by a bag and mask, there is previous history of psychological problems, and there exists an unexplained history of previous postoperative airway distress. The definitive diagnosis may be made using a fibreoptic laryngoscope. In this patient, intubation was deferred and a plan of conservative therapy pursued. Paradoxical vocal cord motion is an unusual cause of postoperative respiratory distress. A definitive diagnosis may be made by the use of a flexible fibreoptic laryngo-scope using topical anaesthesia.

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Citations

Jul 1, 1997·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·S Kleiman, G Tousignant
Oct 8, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Anthony M H HoManoj K Karmakar
Aug 26, 1998·Anesthesiology·K W RobertsJ R Steiniger
Mar 9, 2007·Postgraduate Medical Journal·Wanis H IbrahimTasleem Raza
Jul 21, 2011·Journal of Anaesthesiology, Clinical Pharmacology·Anju Gupta, Nishkarsh Gupta
Jan 23, 2013·Immunology and Allergy Clinics of North America·Flavia C L Hoyte
Mar 23, 2010·Journal of Clinical Anesthesia·Steven M NeusteinMeg A Rosenblatt
Jun 26, 2004·Journal of Clinical Anesthesia·Brian LarsenDouglas B Villariet
Jan 22, 2008·Primary Care·Marcy HicksRohit Katial
Nov 1, 2016·American Journal of Respiratory and Critical Care Medicine·James H HullStephen J Fowler
Jan 14, 2021·Anesthesiology·Jordan D FarleyBenjamin Wallisch
Nov 6, 2010·Chest·Michael J Morris, Kent L Christopher

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