Kurihara Nobuyasu, Imai Kazuhiro, Minamiya Yoshihiro, Saito Hajime, Takashima Shinogu, Kudo Satoshi, Kawaharada Yasushi, Ogawa Jun-Ichi
Department of General Thoracic Surgery (Breast and Endocrine Surgery), Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Gen Thorac Cardiovasc Surg. 2014 Dec;62(12):730-3. doi: 10.1007/s11748-013-0282-9. Epub 2013 Jun 27.
The patient was a 64-year-old woman with no history of laryngeal disorders. She underwent video-assisted right lower lobectomy and node dissection for lung cancer. Using a stylet while the patient was under general anesthesia, tracheal intubation with a 35-French gauge left-sided double-lumen endobronchial tube was successfully performed on the first attempt. The patient developed slight hoarseness on postoperative day 1, and we initially suspected recurrent laryngeal nerve paralysis caused by the surgery, which we elected to treat conservatively. However, because her hoarseness had not improved 4 months after surgery, we evaluated her vocal cords using laryngoscopy. This revealed severe dysfunction of the right vocal cord and arytenoid dislocation, which we treated through reduction using a balloon catheter. By 6 months, the patient's vocal cord mobility had improved. Arytenoid dislocation is a rare complication, but should be suspected when patients have right vocal fold paralysis after lung cancer surgery.
该患者为一名64岁女性，无喉部疾病史。她因肺癌接受了电视辅助右下肺叶切除术和淋巴结清扫术。在患者全身麻醉时使用探条，首次尝试成功插入了一根35号法式规格的左侧双腔支气管导管进行气管插管。患者术后第1天出现轻微声音嘶哑，我们最初怀疑是手术导致的喉返神经麻痹，选择保守治疗。然而，由于术后4个月她的声音嘶哑仍未改善，我们用喉镜检查了她的声带。检查发现右侧声带严重功能障碍和杓状软骨脱位，我们通过气囊导管复位进行了治疗。到6个月时，患者声带活动有所改善。杓状软骨脱位是一种罕见的并发症，但肺癌手术后患者出现右侧声带麻痹时应怀疑此病。
