Endotracheal intubation is a commonly used method for securing airway. It is considered to be safe but it can still lead to some complications of the airway. Recurrent nerve paralysis due to endotracheal intubation is a rare complication. Pathophysiology is explained as neuropraxia of RLN's compression between the tube and the lamina of the thyroid cartilage or between arytenoid and cricoid cartilages due to tube cuff pressure or tube itself. In literature, unilateral vocal cord paralysis (VCP) due to intubation is more common than bilateral paralysis. In the presented case report, a young patient stayed intubated for only 3 days in intensive care unit who experienced bilateral VCP 2 days after extubation. He had total recovery 5 days after emergency tracheotomy suggesting neuropraxia of the nerve. Neuropraxia of RLN resulting in bilateral VCP due to inappropriate size or excess cuff pressure of the intubation tube may be the underlying reasons. The clinicians must be aware of complications of intubation and should apply appropriate treatment method as soon as possible. Appropriate size and cuff pressure should be chosen for endotracheal intubation.
The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.
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