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首页> 外文期刊>Journal of voice: official journal of the Voice Foundation >Neurogenic vocal fold motion impairment after routine intubation for tonsillectomy in a pediatric patient
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Neurogenic vocal fold motion impairment after routine intubation for tonsillectomy in a pediatric patient

机译：小儿患者扁桃体切除术后神经发生的声带运动损伤

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Objectives/Hypothesis: Vocal fold motion impairment is a rare complication of general anesthesia and is more common in older patients undergoing longer duration of anesthesia. We present a case of recurrent laryngeal nerve (RLN) axonotmesis in a 16-year-old patient undergoing general anesthesia for tonsillectomy. Study Design: Case report. Methods: The patient was intubated with a 6-0 oral RAE tube for routine tonsillectomy and was dysphonic postoperatively. Right vocal fold motion impairment was discovered on flexible laryngoscopy, and serial examinations with videostroboscopy were performed. She underwent laryngeal electromyography 3 months postoperatively. Results: Initial videostroboscopy demonstrated findings consistent with right RLN injury. Laryngeal electromyography showed severe active denervation of the right thyroarytenoid muscle with signs of early reinnervation, consistent with axonotmesis. Complete recovery was achieved 4 months postoperatively. Conclusions: This case demonstrates RLN axonotmesis after brief routine intubation. The presumed mechanism of injury is compression of the nerve between the thyroid cartilage and the arytenoid or cricoid cartilage. The use of an oral RAE endotracheal tube may have contributed to the injury owing to the short distance between the bend of the tube and the cuff, placing the cuff at a higher level within the airway.
机译：目标/假设：声带运动障碍是一般麻醉的罕见并发症，在经历较长的麻醉持续时间的老年患者中更常见。我们提出了一种在一个16岁的患者接受扁桃体切除术中的16岁患者中复发性喉神经（RLN）腋窝的情况。研究设计：案例报告。方法：将患者用6-0个口腔管管插管，用于常规扁桃体切除术，术后呼吸困难。在柔性喉镜检查中发现了右声音折叠运动损伤，并进行了与录像带的连续检查。她术后3个月接受了喉部电肌创造。结果：初始录像镜检查显示与右RLN损伤一致的调查结果。喉肌编程显示出右甲状腺囊炎肌的严重活跃，具有早期重新调度的迹象，与腋生相一致。术后4个月实现完全恢复。结论：本例证明了短暂常规插管后的RLN AxoroNotmesis。假定的损伤机制是甲状软骨和骨质或红细胞软骨之间的神经压缩。由于管和袖带的弯曲之间的距离短距离，使用口腔rae气管内膜管的使用可能导致损伤，将袖带放置在气道内的更高水平。

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