双侧声带损伤：前路颈椎间盘切除术前检查能否更好地预防？
Bilateral vocal cord injury following anterior cervical discectomy: could a better preoperative exam have prevented it?
机构信息
Department of Anesthesiology, the Ohio State University Medical Center, Columbus, Ohio, USA.
出版信息
Libyan J Med. 2006 Nov 18;1(2):156-61. doi: 10.4176/061106.
We present a rare case of bilateral vocal cord injury (BVCI) following anterior cervical discectomy with fusion (ACD/F) in a 47 year old man. The patient experienced post-extubation stridor and whispering voice in the recovery room. Clinical assessment led to the diagnosis of BVCI. The patient was treated by tracheostomy and made a full recovery. What is unique about this case is that the patient had no reason for a preexisting unilateral vocal cord injury (UVCI) prior to this surgery. There have been only two similar cases in the English literature in which the patients had a preexisting unilateral vocal cord paralysis (UVCI). We recommend a more detailed preoperative airway exam to include a voice exam with specific voice fatigue questioning on all patients coming for ACD/F. Such detailed assessment may uncover hidden UVCI and allow a safer perioperative period.
我们报告了 1 例罕见的双侧声带损伤（BVCI）病例，该患者为 47 岁男性，在接受前路颈椎间盘切除融合术（ACD/F）后出现双侧声带损伤。患者在恢复室中出现拔管后喘鸣和低语声音。临床评估导致了 BVCI 的诊断。患者接受了气管切开术治疗，并完全康复。该病例的独特之处在于，患者在此次手术前没有单侧声带损伤（UVCI）的原因。英文文献中仅有 2 例类似病例，患者存在单侧声带麻痹（UVCI）。我们建议对所有接受 ACD/F 的患者进行更详细的术前气道检查，包括声带检查和特定的声带疲劳问题询问。这种详细的评估可能会发现潜在的单侧声带损伤，并确保更安全的围手术期。
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