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Superior Laryngeal Nerve Palsy in Revision Anterior Cervical Surgery
Jeffrey A Konopka1, Sheyan J Armaghani, Ashley M Dao
1From the Department of Orthopaedic Surgery (Dr. Konopka, Dr. Armaghani, and Dr. Rhee) and the Department of Otolaryngology (Dr. Dao), Emory University School of Medicine, Atlanta, GA.
Abstract:
Most spine surgeons routinely obtain preoperative ENT evaluation of recurrent laryngeal nerve function when contemplating revision anterior approaches to the cervical spine to avoid the potentially catastrophic consequences of bilateral vocal cord palsy. By contrast, there is less awareness of the potential for superior laryngeal nerve (SLN) injury-although a bilateral injury can, like bilateral injuries of the recurrent laryngeal nerve, have serious clinical consequences. This case report describes a 74-year-old man who, after a contralateral revision anterior approach to the upper cervical spine, developed bilateral SLN injury causing aspiration pneumonia and respiratory failure. We discuss risk factors associated with subclinical SLN injury and define at-risk patients who would benefit from preoperative SLN screening before revision anterior cervical surgery.
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