Bilateral Vocal Cord Palsy after Thyroidectomy Detected by McGrath Videolaryngoscope

Abstract

Bilateral vocal cord palsy (BVCP) is a rare complication of thyroid surgery, and it is confusing and frustrating for both patients and medical staff. We found postoperative vocal cord dysfunction using a McGrath videolaryngoscope from a patient with stridor and dyspnea after thyroidectomy performed with intraoperative recurrent laryngeal nerve monitoring. Soon after, the patient was diagnosed with BVCP by an ENT otolaryngologist using a laryngeal fiberscope. The patient underwent exploration and received a permanent tracheostoma. The possibility of false negative findings from intraoperative nerve monitoring should considered if there is suspicion of BVCP in a high risk patient after thyroidectomy. The McGrath video-laryngoscope can be useful for early discovery of postoperative vocal cord dysfunction.

Techniques of detecting recurrent laryngeal nerve palsy in patients undergoing thyroid surgery: Pearls and pitfalls

“…Various authors have reported or evaluated the performance of various VLs, that is, GlideScope ® ,[ 33 34 ] C-MAC,[ 30 35 ] King Vision,[ 31 ] Truview,[ 31 ] McGrath,[ 36 ] and Airtraq ® [ 9 37 38 ] VLs for visualization of vocal cords to rule out RLN injury at the end of thyroidectomy [ Table 1 ].…”

“…Two case reports have evaluated Airtraq VL, a channeled VL for this indication, and observed a better laryngeal view. [ 9 36 ] Other studies utilizing VLs for this indication have observed that channeled VLs like Airtraq and Pentax AWS provide better Cormack–Lehane (CL) view when compared to unchanneled VLs, although the ease of blade insertion might be better in C-MAC compared to channeled VLs. [ 44 45 ]…”

“…Similarly, Shin et al . [ 36 ] evaluated McGrath VL for visualization of glottic view post-thyroidectomy and found it to be more efficacious than conventional laryngoscopy.…”