title: [Paralysis of the left vocal cord secondary to left recurrent nerve lesion following surgery for ligation of the arterial canal: case report.].
abstract: OBJECTIVE
  Postoperative dysphonia is commonly associated to tracheal intubation and extubation complications, but other causal factors may be involved, including surgical procedures. This article aimed at reporting a late postoperative dysphonia as a consequence of left vocal cord paralysis secondary to left recurrent laryngeal nerve injury during ductus arteriosus ligation procedure.
  
  
  METHODS
  Female patient, 6 years old, physical status ASA II, 18.8 kg, submitted to ductus arteriosus ligation. Patient was premedicated with oral midazolam (0.8 mg.kg-1) 60 minutes before surgery. Anesthesia was induced and maintained with sevoflurane, alfentanil and pancuronium. The ductus arteriosus was difficult to dissect. In the 4th postoperative day, patient presented with persistent dysphonia. Videolaryngoscopy has evidenced paralysis of the left vocal cord and a small paramedian gap.
  
  
  CONCLUSIONS
  For its close relationship with the ductus arteriosus, the left recurrent laryngeal nerve may be damaged during corrective procedures, especially when there are difficulties in ductus arteriosus dissection and ligation. Unlike dysphonias resulting from complications of tracheal intubation and extubation, such dysphonias appear at a later stage, are long-lasting and may be even irreversible.
authors.affiliation: Instituto de Ciências Biológicas, UPE.
authors.forename: Marcius Vinícius M
authors.initials: MV
authors.lastname: Maranhão
authors.forename: Jorge
authors.initials: J
authors.lastname: Pinho Filho