Recurrent laryngeal nerve paralysis during transvenous insertion of a permanent endocardial pacemaker.
We present 2 patients with sudden onset of dysphonia due to acute unilateral vocal cord paralysis that occurred during transvenous insertion of a permanent endocardial pacemaker. Acute paralysis of the vocal cord due to this kind of medical intervention is a very unusual complication that has been rarely reported. We believe that traumatic insertion of a pacemaker through the subclavian vein triggered a dynamic process that led to vocal cord paralysis. Three hypothetic explanations are presented: 1) a direct vagus nerve lesion, 2) a direct inferior laryngeal nerve lesion, and 3) a central nervous system lesion caused by a cerebral microembolus. Physicians should be aware of the possibility that associated acute paralysis of the vocal cord may occur after transvenous insertion of an endocardial pacemaker.
Zohar
Y
Y
Department of Otolaryngology-Head and Neck Surgery, Hasharon Hospital, Golda Medical Center, Petah-Tiqva, Israel.
Buller
N
N
Shvilly
Y
Y
D000208:Acute Disease; D000368:Aged; D016121:Brachiocephalic Veins; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000209:etiology*