Laryngeal nerve monitoring during thyroid surgery in pregnancy.
A 32-week parturient required partial thyroidectomy for suspicious carcinoma. The surgeon requested laryngeal nerve monitoring to decrease the chances of laryngeal nerve injury during surgery. After rapid-sequence induction of general anesthesia and intubation, a size 3 laryngeal mask airway was inserted posterior to the endotracheal tube and the cuff inflated with 15 mL of air. A fiberoptic bronchoscope inserted through the laryngeal mask airway provided an unhindered view of vocal cords for laryngeal nerve identification and testing during surgery. This combined technique also offered the advantages of a secured airway, as well as positive pressure ventilation in the parturient during thyroid surgery.
Shankar
Kodali Bhavani
KB
Department of Anesthesiology and Perioperative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. bhavani@painfreebirthing.com
Posner
Mathew
M
Moore
Francis D
FD
O'Rourke
Nollag
N
D000328:Adult; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D017214:Laryngeal Masks; D007823:Laryngeal Nerves / Q000503:physiopathology*; D016343:Monitoring, Intraoperative; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000601:surgery*; D013965:Thyroidectomy