Abstract
We herein report a case who developed intraoperative complications using the endo-extralaryngeal needle carrier (EENC). The patient was a 35-year-old male who suffered bilateral vocal cord paralysis after undergoing total thyroidectomy. We performed the laterofixation of the paralyzed vocal cord using EENC. After the operation, an initial improvement of the glottic space was achieved but a narrowing of glottic space thereafter gradually developed. We performed operation by the same method using the EENC. The thyroid cartilage was too hard for the needle of the EENC to penetrate it and, as a result, the needle broke off during the procedure. We therefore performed the conventional Ejnell's procedure, and obtained good results just as originally planned. We learned an important lesson from this experience, which can be clarified as follows: 1. When the resistance is strong while inserting the needle with the EENC, then continuous attempts to penetrate the thyroid cartilage by force should be avoided. 2. The indications in cases of a second Ejnell's operation on the same side must be carefully decided. 3. Surgeons should therefore also have mastered the conventional Ejnell's procedure whenever performing lateralization of the vocal cord with the EENC in the event of a need to change the procedure intraoperatively.
