Arndt G A, Voth B R
Department of Anesthesiology, University of Wisconsin Clinical Science Center, Madison 53792-3272, USA.
Can J Anaesth. 1996 Dec;43(12):1249-51. doi: 10.1007/BF03013434.
We report a case of paradoxical vocal cord motion as an unusual cause of postoperative stridor and wheezing. A means of diagnosis and management is discussed.
A 71-yr-old man developed paradoxical vocal cord motion following uncomplicated hip replacement. He was treated with standard therapy for postoperative stridor and wheezing. After extensive evaluation, a flexible fibreoptic laryngoscope was used and the vocal cords noted to move paradoxically. This was the cause of his postoperative stridor and wheezing. Paradoxical vocal cord motion should be suspected as a cause of postoperative stridor and wheezing when the airway is easily maintained by a bag and mask, there is previous history of psychological problems, and there exists an unexplained history of previous postoperative airway distress. The definitive diagnosis may be made using a fibreoptic laryngoscope. In this patient, intubation was deferred and a plan of conservative therapy pursued.
Paradoxical vocal cord motion is an unusual cause of postoperative respiratory distress. A definitive diagnosis may be made by the use of a flexible fibreoptic laryngo-scope using topical anaesthesia.
我们报告一例反常性声带运动作为术后喘鸣和喘息不寻常病因的病例。并讨论其诊断和处理方法。
一名71岁男性在无并发症的髋关节置换术后出现反常性声带运动。他接受了术后喘鸣和喘息的标准治疗。经过广泛评估，使用了可弯曲纤维喉镜，发现声带出现反常运动。这就是他术后喘鸣和喘息的病因。当气道通过面罩通气容易维持、既往有心理问题史且有无法解释的既往术后气道窘迫史时，应怀疑反常性声带运动是术后喘鸣和喘息的病因。可使用纤维喉镜做出明确诊断。在该患者中，推迟了插管并采取了保守治疗方案。
反常性声带运动是术后呼吸窘迫的不寻常病因。使用表面麻醉的可弯曲纤维喉镜可做出明确诊断。
