RT  - Signa Vitae
ID  - 10.22514/SV82.102013.9
T1  - Late manifestation of bilateral laryngeal nerve palsy after thyroidectomy
A1  - TOBIAS SCHULZE
A1  - STEPHAN KNIGGE
A1  - CLAUS-DIETER HEIDECKE
A1  - STEFAN MAIER
K1  - bilateral recurrent laryn-geal nerve palsy
K1  - respiratory distre-ss
K1  - thyroidectomy
K1  - goiter
K1  - postope-rative complication
YR  - 2013
SP  - 56
AB  - <p>Respiratory distress is a feared complication after thyroid surgery. Differential diagnosis includes bilateral recurrent laryn-geal nerve palsy (BRLNP), local hematoma, vocal cord edema and laryngeal trauma. BRLNP results from intraoperative irritation without physical injury (neurapraxia), or intraoperative partial or complete transsection (axonotmesis and neuro-tmesis, respectively) of the recurrent laryngeal nerve (RLN). RLN palsy typically manifests immediately in the postoperative course. However, in rare cases there is a delayed, progressive development of BRLNP, potentially leading to respiratory failure in emergency setting weeks after initial surgery. Herein we report on a patient developing massive respiratory distress secondary to BRLNP 5 weeks after thyroidectomy for massive goiter. With the current tendency to decrease the length of hospital stay after thyroid surgery, late onset palsy of the RLN should be included into the differential diagnosis for acute respiratory distress in patients with recent history of thyroid surgery.&nbsp;</p>