Vocal cord paralysis - an intubation lesion?

Introduction: Vocal cord paralysis is a important complication in thyroid g land surgery. A prospective study was conducted ascertain the frequency of laryngeal nerve palsy not caused by surgical trauma. Patients and Methods: Two hundred and ten patients were investigated laryngoscopically pre- and p ostoperatively after short-term intubation in the course of operations far removed from thorax or neck region. We noted the inner diameter of the tube , intubation problems, the qualification of the anaesthesiologist and the p ositioning of the patient. Results: Preoperatively we found previously unkn own unilateral laryngeal nerve palsy in 1.9 % of cases. Postoperatively the re were pathological findings of vocal cords in 13 patients (6.2 %). In 10 patients a direct lesion (oedema, rubor, haematoma, granuloma) was establis hed. Three patients (1.4%) were found to have a movement disorder caused by a neural lesion without morphological findings, leading to restitutio ad i ntegrum in two of three cases after 6 months. Conclusion: The frequency of intubation-related recurrent nerve palsy is 1.4 % transiently and 0.5 % per manently. The reasons are discussed. Preoperative laryngoscopic investigati on of vocal cords should be carried out before intubation.