Arıkan Akif Enes, Teksöz Serkan, Bilgin İsmail Ahmet, Tarhan Özge, Özyeğin Ateş
Department of General Surgery, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
Department of Ear, Nose and Throat, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
Turk J Surg. 2015 Jul 14;33(4):305-307. doi: 10.5152/UCD.2015.3044. eCollection 2017.
Although vocal cord paralysis (VCP) following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis following thyroidectomy can be caused by a vocal cord hematoma with an incidence of 1.4% due to direct injury during orotracheal intubation. In this article, we present a case of VCP caused by vocal cord hematoma. A 32-year-old male patient who has been receiving propylthiouracil treatment for toxic multinodular goiter since 10 years was admitted to our hospital to be operated because of persisting complaints. The patient was hospitalized for sutureless thyroidectomy after he became euthyroid. Preoperative fiberoptic laryngoscopy performed by the ear, nose, and throat department revealed bilaterally motile vocal folds and a completely open airway. Patient underwent sutureless total thyroidectomy with a vessel sealing device (Ligasure LF1212, Covidien, CO), and a minivac drainage system was placed in the thyroid lodge. On the morning of the first postoperative day, 50 mL of serosanguinous fluid was drained. The patient's voice was normal, and there was no ecchymosis. Postoperative fiberoptic laryngoscopy revealed a hematoma near the right vocal fold and paralysis of the right vocal fold; however, the airway was open. It should be kept in mind that VCP is not solely due to surgery but can also result from intubation, as observed in this case.
尽管甲状腺切除术后声带麻痹（VCP）主要与手术创伤有关，但它并非唯一病因。甲状腺切除术后声带麻痹可由声带血肿引起，由于经口气管插管期间的直接损伤，其发生率为1.4%。在本文中，我们报告一例由声带血肿引起的VCP病例。一名32岁男性患者，自10年前起因毒性多结节性甲状腺肿接受丙硫氧嘧啶治疗，因持续不适入院接受手术。患者甲状腺功能恢复正常后住院接受无缝线甲状腺切除术。术前由耳鼻喉科进行的纤维喉镜检查显示双侧声带活动，气道完全通畅。患者使用血管闭合装置（Ligasure LF1212，柯惠医疗，CO）进行了无缝线全甲状腺切除术，并在甲状腺窝放置了微型引流系统。术后第一天早晨，引流出50毫升血性浆液。患者声音正常，无瘀斑。术后纤维喉镜检查显示右声带附近有血肿，右声带麻痹；然而，气道通畅。应牢记，如本病例所示，VCP并非仅由手术引起，插管也可能导致。
