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Pulmonary oedema after airway obstruction due to bilateral vocal cord paralysis

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Abstract

We report a case of pulmonary oedema which developed after airway obstruction due to bilateral vocal cord paralysis. The patient was a 52-yr-old woman undergoing craniotomy for an acoustic neuroma. Anaesthesia was uneventful. Spontaneous ventilation resumed after reversal of neuromuscular blockade. Following extubation she showed signs of airway obstruction and dyspnoea. The trachea was reintubated but she became hypoxic, PaO2 -36mmHg, produced pink frothy secretions and the x-ray was typical of pulmonary oedema. The oedema cleared within 24 hr. Tracheostomy was performed one week later as the cords were still fixed, but the latter had recovered by three months and the tracheostomy was closed. The cause of the cord paralysis is unknown but probably was a result of surgical trauma to the brain stem.

Résumé

On rapporte le cas d’un patient ayant de’veloppe un a?deme pulmonaire aigue aprés obstruction des voies aeriennes suite à une paralysie bilatérale des cordes vocales. La paliente âgée de 52 ans à subi une craniotomie pour un neuroninone acoustique. L’anesthésie fut accomplie sans incident. La ventilation spontanée fut reprise après antagonisme du blocage neuromusculaire. Apres l’extubation, la patienle à démontré des signes dobstruction des voies aériennes et de la dyspnée. La trachée fut reintubée mais la patiente devint hypoxique, PaO2 −36 mmHg, et on a observé des sécrétions spumeuses rosées et le rayon-x a démontré un adème pulmonaire typique. L’œdéme a régressé en dedans de 24 heures. Une tracheostomie fut faite une semaine plus tard car les cordes vocales étaient encore fermées et la récupération s’ensuivie trois mois plus tard, c’est alors que la trachéostomie fut fermée. La cause de la paralysie des cordes vocales n’est pas connue mais serait due probablement au trauma chirurgical.

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Correspondence to Shuji Dohi.

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Dohi, S., Okubo, N. & Kondo, Y. Pulmonary oedema after airway obstruction due to bilateral vocal cord paralysis. Can J Anaesth 38, 492–495 (1991). https://doi.org/10.1007/BF03007586

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Key Words

  • airway: obstruction
  • lung: oedema