Postoperative recurrent nerve paralysis can cause severe complications such as aspiration pneumonia after lung surgery or aortic surgery. After thoracic surgery, we examine the larynx with a laryngoscope immediately after tracheal extubation in the operation room or intensive care unit. When we find unilateral recurrent nerve paralysis, we tell the surgeon, anesthetist, and nurse to prevent aspiration pneumonia. Then we continue to follow laryngeal examination post-discharge. When recurrent nerve paralysis does not improve, we perform surgery, such as thyroplasty type 1 and laryngeal nerve reinnervation.
We analyzed the examination of the larynx, vocal cord paralysis, the results of tracking, and voice before and after phonosurgery. Between 2012 and 2017, 214 patients who received lung surgery and 231 patients who received aortic surgery were analyzed.
Larynx examinations were performed for 192 patients who received lung surgery, we found 21 vocal cord paralysis cases and performed phonosurgery in 6 cases. Meanwhile larynx examinations were performed for 120 patients who received aortic surgery, we found 30 vocal cord paralysis cases and performed phonosurgery in 2 cases. After phonosurgery, the MPT of 8 cases was longer in comparison to before the operation.
We examine larynx immediately after extubation, rather than after hoarsness occurs, in order to clarify risk of aspiration pneumonia and maintain safe from the early stage.
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