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The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

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Published on: August 2, 2024

Post tracheal extubation stridor.

Nigel Hollister¹, Harith Altemimi, Martyn West

¹Intensive Care Department, Derriford Hospital, Devon, UK. nigel.hollister@doctors.org.uk

BMJ Case Reports

|June 13, 2012

Summary

This summary is machine-generated.

A rare case of post-extubation stridor led to tracheostomy after interscalene nerve blockade caused bilateral recurrent laryngeal nerve palsies. This highlights the importance of preoperative assessment for nerve palsies to prevent such complications.

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Area of Science:

Anesthesiology
Neurology
Otolaryngology

Background:

Post-extubation stridor is a potential complication following airway management.
Recurrent laryngeal nerve palsy can be unilateral or bilateral, affecting vocal cord function.
Regional anesthesia techniques, like interscalene nerve blockade, carry specific risks.

Observation:

An unusual case of severe post-extubation stridor necessitated tracheostomy.
The patient had an undiagnosed contralateral recurrent laryngeal nerve palsy.
Interscalene nerve blockade was performed for regional anesthesia.

Findings:

The interscalene nerve blockade resulted in bilateral recurrent laryngeal nerve palsies.
This bilateral palsy led to the severe stridor and need for tracheostomy.
Undetected contralateral nerve palsy significantly increased the risk of this adverse event.

Implications:

Emphasizes the critical need for thorough preoperative assessment to identify pre-existing nerve palsies.
Highlights the potential for regional anesthesia to exacerbate or unmask neurological deficits.
Underscores the importance of understanding differential diagnoses for stridor and nerve palsies in clinical practice.