title: Sleep-disordered breathing as a delayed complication of iatrogenic vocal cord trauma.
abstract: A case of a 55-year-old woman with iatrogenic vocal cord trauma and sleep-related symptoms is reported. In particular, this case highlights sleep-disordered breathing as a delayed complication after iatrogenic vocal cord trauma. The patient developed acute stridor from a contralateral vocal cord hematoma following vocal fold injection for right vocal cord paralysis. Acute respiratory symptoms resolved with oxygen, steroids, and nebulized therapy, but nocturnal symptoms persisted and polysomnography revealed sleep-related hypoventilation and mild obstructive sleep apnea. Positive pressure therapy was successfully used to ameliorate her symptoms and treat sleep-disordered breathing until her hematoma resolved. In addition to the typically acute respiratory symptoms that may result from vocal cord dysfunction, sleep-disordered breathing may also present as a significant subacute or chronic problem. Management of the acute respiratory symptoms is relatively well established, but clinicians should be alert for more subtle nocturnal symptoms that may require further study with polysomnography.
authors.affiliation: Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: safaiz@mdanderson.org.
authors.forename: Saadia A
authors.initials: SA
authors.lastname: Faiz
authors.affiliation: Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Bashoura
authors.affiliation: Divisions of Pulmonary, Critical Care Medicine and Sleep Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Kodali
authors.affiliation: Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Hessel
authors.affiliation: Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Evans
authors.affiliation: Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Diwakar D
authors.initials: DD
authors.lastname: Balachandran
mesh_terms: D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D017286:Polysomnography; D000072078:Positron Emission Tomography Computed Tomography; D012135:Respiratory Sounds; D020181:Sleep Apnea, Obstructive / Q000209:etiology*; D014826:Vocal Cord Paralysis / Q000150:complications*
keywords: Continuous positive airway pressure; Obstructive sleep apnea; Sleep-disordered breathing; Sleep-related hypoventilation; Vocal cord dysfunction; Vocal cord paralysis