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Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale

Revision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelo...

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Autores principales: Wu, Cheng Han, Yang, Eugene Wei Ren, Lor, Kelvin Kah Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: China Medical University 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823468/
https://www.ncbi.nlm.nih.gov/pubmed/35223395
http://dx.doi.org/10.37796/2211-8039.1114
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author Wu, Cheng Han
Yang, Eugene Wei Ren
Lor, Kelvin Kah Ho
author_facet Wu, Cheng Han
Yang, Eugene Wei Ren
Lor, Kelvin Kah Ho
author_sort Wu, Cheng Han
collection PubMed
description Revision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelopathy, and in whom pre-operative laryngoscopic evaluation had excluded a pre-existing occult RLNP. Scarring around the recurrent laryngeal nerve at the previous surgical site may have rendered it less mobile, resulting in it being more susceptible to compression from an inflated endotracheal tube (ETT) cuff or traction from surgical retractors. This case illustrates that acute RLNP can rarely occur contralateral to the side of surgical approach in the setting of revision surgery. Surgeons performing revision ACDF can consider approaching from the same side as the index surgery or a posterior approach to reduce the risk of developing bilateral RLNP.
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spelling pubmed-88234682022-02-25 Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale Wu, Cheng Han Yang, Eugene Wei Ren Lor, Kelvin Kah Ho Biomedicine (Taipei) Case Report Revision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelopathy, and in whom pre-operative laryngoscopic evaluation had excluded a pre-existing occult RLNP. Scarring around the recurrent laryngeal nerve at the previous surgical site may have rendered it less mobile, resulting in it being more susceptible to compression from an inflated endotracheal tube (ETT) cuff or traction from surgical retractors. This case illustrates that acute RLNP can rarely occur contralateral to the side of surgical approach in the setting of revision surgery. Surgeons performing revision ACDF can consider approaching from the same side as the index surgery or a posterior approach to reduce the risk of developing bilateral RLNP. China Medical University 2021-03-01 /pmc/articles/PMC8823468/ /pubmed/35223395 http://dx.doi.org/10.37796/2211-8039.1114 Text en © the Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Case Report
Wu, Cheng Han
Yang, Eugene Wei Ren
Lor, Kelvin Kah Ho
Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
title Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
title_full Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
title_fullStr Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
title_full_unstemmed Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
title_short Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
title_sort contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (acdf): a cautionary tale
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823468/
https://www.ncbi.nlm.nih.gov/pubmed/35223395
http://dx.doi.org/10.37796/2211-8039.1114
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