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A 14 year-old girl is 18 hours status post a thyroidectomy for treatment of Graves disease that was refractory to medical therapy. There were no intraoperative complications. You are called to the bedside because she complains of trouble breathing and swallowing liquids. Her voice is “breathy” and hoarse and she is unable to speak in long sentences. This is most likely due to:

a) Hypocalcemia due to hypoparathyroidism

b) Unilateral vocal cord paralysis from damage to the recurrent laryngeal nerve (RLN)

c) Bilateral vocal cord paralysis from damage to the RLN

d) Enlarging incisional hematoma causing tracheal compression

e) Thyroid storm

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Answer

Answer b. Unilateral vocal cord injury due to recurrent laryngeal nerve palsy presents as postoperative hoarseness and dysphagia or aspiration and occurs in

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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