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Vocal fold paralysis due to intracranial hypotension following spinal anesthesia

Stimmlippenlähmung durch intrakranielle Hypotonie nach Spinalanästhesie

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Abstract

Cranial nerve palsy is a rare neurological complication of epidural and subarachnoid blocks. Most of these complications are attributed to secondary intracranial hypotension due to cerebrospinal fluid leakage following dural puncture. Vocal fold paralysis (VFP) seems more likely to be overlooked and underreported due to delayed onset of symptoms and lack of attribution of dysphonia to spinal anesthesia. Therefore, VFP can often be missed and described as idiopathic. This article describes a case of VFP due to vagus nerve injury following subarachnoid block.

Zusammenfassung

Hirnnervenlähmungen sind eine seltene neurologische Komplikation nach Epidural- und Subarachnoidalblockaden. Meist werden sie auf eine sekundäre intrakranielle Hypotonie aufgrund von Liquoraustritt nach einer Durapunktion zurückgeführt. Eine konsekutive Stimmlippenlähmung scheint eher übersehen zu werden und insgesamt unterschätzt zu sein, da die Symptome verzögert auftreten und die Dysphonie nicht auf die Spinalanästhesie zurückgeführt wird. Eine Stimmlippenlähmung wird oft nicht erkannt und die Dysphonie dann als idiopathisch bezeichnet. Im Beitrag vorgestellt wird eine Patientin mit Stimmlippenlähmung aufgrund einer N.-vagus-Verletzung nach Subarachnoidalblockade.

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, University of Health Sciences Derince Training and Research Hospital, 41900, Kocaeli, Turkey

    H. Gurbuz Aytuluk

  2. Department of Otorhinolaryngology, Kocaeli State Hospital, Kocaeli, Turkey

    O. Aktas

Authors
  1. H. Gurbuz Aytuluk
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  2. O. Aktas
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Correspondence to H. Gurbuz Aytuluk.

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H. G. Aytuluk and O. Aktas declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Aytuluk, H.G., Aktas, O. Vocal fold paralysis due to intracranial hypotension following spinal anesthesia. Anaesthesist 67, 868–870 (2018). https://doi.org/10.1007/s00101-018-0501-y

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  • DOI: https://doi.org/10.1007/s00101-018-0501-y

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