Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon - Bourgogne, Dijon, France.
INSERM U1231, University of Burgundy Franche-Comté, Dijon, France.
BMC Gastroenterol. 2020 May 14;20(1):153. doi: 10.1186/s12876-020-01300-4.
Oesophageal stents have several well-known respiratory complications, including aspiration pneumonia, fistula and airway compression. However, bilateral vocal cord paralysis has rarely been described.
We describe two patients who presented with refractory dysphagia due to malignant proximal oesophageal strictures. Both received palliative treatment consisting of fully covered self-expandable metal stents that were placed across the strictures.
Both patients developed inspiratory stridor and acute hypoxemic respiratory failure shortly after the stent was placed. Flexible bronchoscopy revealed vocal cord paralysis in paramedian position, potentially due to extrinsic compression of the posterior branch of the recurrent laryngeal nerve following the progressive opening of the esophageal prosthesis. One patient recovered after the stent was removed.
Bilateral vocal cord paralysis is a rare but potentially fatal complication of proximal esophagus stenting.
食管支架有多种众所周知的呼吸系统并发症，包括吸入性肺炎、瘘管和气道压迫。然而，双侧声带麻痹很少被描述。
我们描述了两名因恶性食管上段狭窄而出现难治性吞咽困难的患者。两名患者均接受了姑息治疗，包括在狭窄部位放置全覆膜自膨式金属支架。
两名患者在支架放置后不久均出现吸气性喘鸣和急性低氧性呼吸衰竭。纤维支气管镜检查显示声带麻痹位于旁正中位置，可能是由于食管假体逐渐张开后，喉返神经后支受到外在压迫所致。一名患者在移除支架后恢复。
双侧声带麻痹是食管上段支架置入的一种罕见但潜在致命的并发症。
