Ga. Arndt et Br. Voth, PARADOXICAL VOCAL CORD MOTION IN THE RECOVERY ROOM - A MASQUERADER OFPULMONARY DYSFUNCTION, Canadian journal of anaesthesia, 43(12), 1996, pp. 1249-1251
Purpose: We report a case of paradoxical vocal cord motion as an unusu
al cause of postoperative strider and wheezing. A means of diagnosis a
nd management is discussed. Clinical findings: A 71-yr-old man develop
ed paradoxical vocal cord motion following uncomplicated hip replaceme
nt. He was treated with standard therapy for postoperative strider and
wheezing. After extensive evaluation a flexible fibreoptic laryngosco
pe was used and the vocal cords noted to move paradoxically. This was
the cause of his postoperative strider and wheezing. Paradoxical vocal
cord motion should be suspected as a cause of postoperative strider a
nd wheezing when the airway is easily maintained by a bag and mask, th
ere is previous history of psychological problems, and there exists an
unexplained history of previous postoperative airway distress. The de
finitive diagnosis may be made using a fibreoptic laryngoscope. In thi
s patient, intubation was deferred and a plan of conservative therapy
pursued. Conclusion: 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 laryngoscope using topical an
aesthesia.