抄録
A 58-year-old woman with diffuse goiter underwent an expansive laminectomy of the spinal canal under general anesthesia in the prone and head down position. Her trachea was intubated uneventfully with a spiral tube (7.0-mm I.D.), and the cuff was filled with air (3 ml). It took 2 hours and 40 minutes to finish the surgical procedure. After extubation, stridor was noticed. Flexible laryngoscopic examination revealed stenosis of the glottis caused by bilateral laryngeal nerve paralysis, and a tracheotomy was performed. The paralysis disappeared within two weeks and the tracheal stoma was closed. The cause of the laryngeal nerve paralysis after endotracheal intubation is usually considered to be a local circulatory disorder produced by the endotracheal tube and cuff. In this case, however, the patient with diffuse goiter condition and the head down position may have been causes of the paralysis, because the other possible factors were negligible.
