Laryngospasm after Superior Laryngeal Nerve Block: a Case Report
Article Sidebar
Main Article Content
Abstract
Medialization thyroplasty is a surgical treatment for vocal cord paralysis, a condition often associated with varying degrees of aspiration. The first step of this procedure invloves performing superior laryngeal nerve blocks using a local anesthetic agent. Performing a superior laryngeal nerve block in patients who have undergone radiation therapy and lymph node dissection can be challenging due to potential anatomical abnormalities. These abnormalities may cause the anesthetic injection, when performed using conventional landmark techniques, to penetrate deeper than the intended layer. This may lead to certain life-threatening complications, such as laryngospasm, as described in this case report. Therefore, using ultrasound guidance to perform the superior laryngeal nerve block can enhance the accuracy of the anesthetic injection. Additionally, sedation must be administered cautiously to avoid respiratory depression, as complications such as laryngospasm may occur in this patient.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Ng SK, Li HN, Chan JY, Wong EWY, Vlantis AC. A useful landmark to locate the external branch of the superior laryngeal nerve during thyroidectomy. Gland Surg. 2020;9:647-52.
Zhipeng L, Meiyi H, Meirong W, et al. Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: a randomized controlled trial. PLoS One. 2020;15:e0241834.
Kojima Y, Sugimura M. Superior laryngeal nerve block for intubation in patients with COVID-19. Anesth Prog. 2021;68:50-1.
Dankbaar JW, Pameijer FA. Vocal cord paralysis: anatomy, imaging and pathology. Insights Imaging. 2014;5:743-51.
Furby A, Behin A, Lefaucheur JP, et al. Late-onset cervicoscapular muscle atrophy and weakness after radiotherapy for Hodgkin disease: a case series. J Neurol Neurosurg Psychiatry. 2010;81:101-4.
Ghosh PS, Milone M. Clinical and laboratory findings of 21 patients with radiation-induced myopathy. J Neurol Neurosurg Psychiatry. 2015;86:152-8.
Kim J, Shin ES, Kim JE, Yoon SP, Kim YS. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer. Radiat Oncol J. 2015;33:344-9.
Ohtawa T, Katagiri M, Harada T. A study of sternocleidomastoid muscular atrophy after modified neck dissection. Surg Today. 1998;28:46-58.
Lima LP, Amar A, Lehn CN. Spinal accessory nerve neuropathy following neck dissection. Braz J Otorhinolaryngol. 2011;77:259-62.
Bao Y, Xiong J, Wang H, Zhang Y, Zhong Q, Wang G. Ultrasound-guided block of the internal branch of the superior laryngeal nerve reduces postoperative sore throat caused by suspension laryngoscopic surgery: a prospective randomized trial. Front Surg. 2022;9:829811.
Akhaddar A, Baallal H, Hammoune N, Bouabbadi S, Adraoui A, Belfquih H. Unilateral blindness following superior laryngeal nerve block for awake tracheal intubation in a case of posterior cervical spine surgery. Surg Neurol Int. 2020;11:277.
Ambi US, Arjun BK, Masur S, Endigeri A, Hosalli V, Hulakund SY. Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: a prospective randomised clinical study. Indian J Anaesth. 2017;61:463-8.
Wang Y, Feng C, Fu J, Liu D. Clinical application of ultrasound-guided internal branch of superior laryngeal nerve block in patients with severe COPD undergoing awake fibreoptic nasotracheal intubation: a randomized controlled clinical trial. Int J Chron Obstruct Pulmon Dis. 2023;18:521-32.
Magadum NB, Nileshwar A, Vijayakumara. Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation-an observational study. J Anaesthesiol Clin Pharmacol. 2023;39:226-31.
El Sherif FA, Abdel-Ghaffar H, Othman A, et al. Pharmacokinetics and pharmacodynamics of dexmedetomidine administered as an adjunct to bupivacaine for transversus abdominis plane block in patients undergoing lower abdominal cancer surgery. J Pain Res. 2022;15:1-12.
Chen Z, Liu Z, Feng C, Jin Y, Zhao X. Dexmedetomidine as an adjuvant in peripheral nerve block. Drug Des Devel Ther. 2023;17:1463-84.
