title: Unilateral vocal fold adductor paralysis after tracheal intubation.
abstract: Vocal fold immobility is a relatively rare complication that can occur after tracheal intubation. Differential diagnoses include a rare clinical entity called unilateral vocal fold adductor paralysis in which only branches entering the thyroarytenoid and lateral cricoarytenoid muscles of the recurrent laryngeal nerve become paralyzed. Computed tomography and laryngeal electromyography are required to distinguish this condition from others such as cricoarytenoid dislocation/subluxation. Here, we describe two patients who developed vocal fold adductor paralysis after intubation. Patient 1 was a 56-year-old man who underwent living-donor liver transplantation and was extubated on day 7 after surgery. Patient 2 was a 52-year-old man who received life support measures including intubation due to ventricular fibrillation, and was extubated two days later. Both were hoarse soon after extubation. Endoscopic laryngeal examination revealed normal abduction and insufficient adduction of paralyzed vocal folds. Computed tomography ruled out cricoarytenoid dislocation/subluxation and laryngeal electromyography confirmed unilateral vocal fold adductor paralysis. Laryngologists should consider this rare pathogenesis.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. Electronic address: tgotou-tky@umin.ac.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Goto
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Nito
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Rumi
authors.initials: R
authors.lastname: Ueha
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Yamauchi
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
mesh_terms: D004576:Electromyography; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007821:Laryngeal Muscles / Q000033:anatomy & histology / Q000294:innervation; D007823:Laryngeal Nerves / Q000033:anatomy & histology; D007828:Laryngoscopy; D007830:Larynx / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: Arytenoid dislocation/subluxation; Laryngeal electromyography; Tracheal intubation; Vocal fold adductor paralysis