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Transient Aphonia After Mediastinoscopy
Frank O Velez-Cubian1, Kavian Toosi2, Jessica Glover2
1Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida.
The Annals of Thoracic Surgery
|May 22, 2017
Summary
A rare complication of cervical mediastinoscopy, recurrent laryngeal nerve (RLN) injury, caused temporary vocal cord paralysis in a non-small cell lung cancer patient. The paralysis resolved spontaneously without intervention.
Area of Science:
- Thoracic Surgery
- Otolaryngology
- Anesthesiology
Background:
- Cervical mediastinoscopy is a common procedure for staging non-small cell lung cancer (NSCLC).
- Recurrent laryngeal nerve (RLN) injury is the most frequent adverse event, with an incidence of 0.6%.
Observation:
- A 68-year-old man with NSCLC developed complete aphonia post-mediastinoscopy.
- The patient experienced transient bilateral vocal cord paralysis, requiring close airway monitoring.
Findings:
- Vocal cord paralysis resolved spontaneously within 5 hours without the need for intubation or tracheostomy.
- This is the first reported case of bilateral RLN paralysis attributed to bupivacaine diffusion after cervical mediastinoscopy.
Implications:
- Bupivacaine administration at the conclusion of cervical mediastinoscopy may pose a risk of transient RLN paralysis.
- Awareness of this potential complication is crucial for patient monitoring and management.
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