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Vocal fold paralysis following spinal anesthesia.

Elizabeth Guardiani1, Lucian Sulica2

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore.

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|May 17, 2014
PubMed
Summary
This summary is machine-generated.

Spinal anesthesia can cause vocal fold paralysis (VFP) due to intracranial hypotension. This study presents four cases of transient VFP following spinal anesthesia, highlighting a rare but possible complication.

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Area of Science:

  • Neurology
  • Anesthesiology
  • Otolaryngology

Background:

  • Transient upper cranial neuropathies are known complications of spinal anesthesia.
  • Lower cranial neuropathies, specifically vagal neuropathies, are not well-documented following spinal anesthesia.

Purpose of the Study:

  • To present cases of vocal fold paralysis (VFP) following spinal anesthesia.
  • To propose a mechanism for VFP as a complication of spinal anesthesia.

Main Methods:

  • Case series of three women presenting with dysphonia after spinal anesthesia.
  • Clinical examination and imaging to rule out other causes of VFP.
  • Follow-up assessment of vocal fold motion recovery.

Main Results:

  • Four instances of unilateral VFP were identified in three patients post-spinal anesthesia.
  • No patient had undergone intubation or had a central line on the side of the weakness.
  • All patients showed significant recovery of vocal fold motion within six months.

Conclusions:

  • Intracranial hypotension secondary to spinal anesthesia may cause vagal neuropathy.
  • Transient vocal fold palsy is a potential, albeit rare, complication of spinal anesthesia.