title: An unusual cause of difficult weaning in a patient with newly diagnosed small cell lung cancer.
abstract: We describe a patient with acute respiratory insufficiency and difficult ventilator weaning in the ICU ward, leading to diagnosis of small cell lung cancer with superior vena cava superior syndrome. Bilateral vocal cord paralysis caused his respiratory distress and weaning difficulties. Thyroidectomy and neurological problems (such as Parkinson disease and Guillain Barré syndrome) are more common causes of bilateral vocal cord paralysis. Lung cancer patients are also at risk due to mediastinal invasion. The left recurrent laryngeal nerve is more prone to paralysis because of the typical anatomy. In contrary, bilateral vocal cord paralysis is rare and doesn't result in speech problems but rather breathing difficulties. Tracheostomy is the classic therapy, but laser cordectomy and Botulinum toxin injection in the laryngeal muscles are alternatives.
authors.affiliation: University Hospitals Leuven, Dept. of Respiratory Medicine, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Deslypere
authors.affiliation: Jessa Hospital Hasselt, Dept. of Respiratory Medicine and Thoracic Oncology, Stadsomvaart 11, 3500 Hasselt, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Cuppens
authors.affiliation: Jessa Hospital Hasselt, Dept. of Respiratory Medicine and Thoracic Oncology, Stadsomvaart 11, 3500 Hasselt, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Pat
authors.affiliation: Jessa Hospital Hasselt, Dept. of Respiratory Medicine and Thoracic Oncology, Stadsomvaart 11, 3500 Hasselt, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Aumann
authors.affiliation: Jessa Hospital Hasselt, Dept. of Respiratory Medicine and Thoracic Oncology, Stadsomvaart 11, 3500 Hasselt, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Demuynck
authors.affiliation: Jessa Hospital Hasselt, Dept. of Respiratory Medicine and Thoracic Oncology, Stadsomvaart 11, 3500 Hasselt, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Spaas
keywords: Bilateral vocal cord paralysis; Small cell lung cancer