Baek J, Jee DL, Choi YS, Kim SW, Choi EK. Paradoxical vocal fold motion masquerading as post-anesthetic respiratory distress: A case report. World J Clin Cases 2023; 11(10): 2349-2354 [PMID: 37122517 DOI: 10.12998/wjcc.v11.i10.2349]
Corresponding Author of This Article
Eun Kyung Choi, MD, PhD, Assistant Professor, Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. zzini0527@naver.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2023; 11(10): 2349-2354 Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2349
Paradoxical vocal fold motion masquerading as post-anesthetic respiratory distress: A case report
Jongyoon Baek, Dae-Lim Jee, Yoon Seok Choi, Sang Woo Kim, Eun Kyung Choi
Jongyoon Baek, Dae-Lim Jee, Eun Kyung Choi, Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
Yoon Seok Choi, Department of Otorhinolaryngology-Head and Neck Surgery, Yeungnam University College of Medicine, Daegu 42415, South Korea
Sang Woo Kim, Department of Neurosurgery, Yeungnam University College of Medicine, Daegu 42415, South Korea
Author contributions: Baek J and Choi EK contributed to the investigation, original draft writing, and manuscript reviewing and editing; Jee DL contributed to supervision and manuscript reviewing and editing; Choi YS and Kim SW contributed to manuscript reviewing and editing; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eun Kyung Choi, MD, PhD, Assistant Professor, Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. zzini0527@naver.com
Received: December 22, 2022 Peer-review started: December 22, 2022 First decision: January 9, 2023 Revised: January 18, 2023 Accepted: March 15, 2023 Article in press: March 15, 2023 Published online: April 6, 2023
Abstract
BACKGROUND
Functional vocal cord disorders can be a differential diagnosis for postoperative upper airway obstruction requiring urgent intervention. However, this may be unfamiliar to anesthesiologists who would favor inappropriate airway intervention and increased morbidity.
CASE SUMMARY
A 61-year-old woman underwent cervical laminectomy, followed by laparoscopic cholecystectomy 10 mo later. Despite adequate reversal of neuromuscular blockade, the patient experienced repetitive respiratory difficulty with inspiratory stridor after extubation. After the second operation, the patient was diagnosed with paradoxical vocal fold motion (PVFM) by an otolaryngologist based on the clinical features and fiberoptic bronchoscopy results, and the patient was successfully treated.
CONCLUSION
PVFM should be considered a differential diagnosis if a patient presents with stridor after general anesthesia.
Core Tip: Postoperative upper airway obstruction after general anesthesia requires urgent airway intervention. Postoperative stridor is a common cause of laryngeal spasm, but functional vocal cord disorders may also be a cause. However, anesthesiologists may be unfamiliar with functional vocal cord disorders, and this may lead to inappropriate interventions. We present the case of a patient with post-extubation repetitive stridor who was postoperatively diagnosed with paradoxical vocal fold motion (PVFM) by an otolaryngologist and discuss the diagnosis and treatment of PVFM. Our case presentation showed that PVFM should be considered in the differential diagnosis of postoperative stridor.
