Reyes-Martínez DI, Ramírez-Segura EH, De Obieta-Cruz E, Vega-Sosa A

Language: Spanish
References: 8
Page: 162-166
PDF size: 366.98 Kb.

ABSTRACT

Recurrent laryngeal nerve injury (RLN) is the most common complication in anterior cervical spine surgery, where the most frequent mechanism is traction-compression, this type of approach is the one of choice since it allows more precise access to anatomical structures such as dura mater, nerve roots, vertebral arteries and stabilizing the cervical spine. According to literature, the injury of RLN occurs in an incidence of 7 to 11%, in our experience, a balloon deflation of the endotracheal tube is performed, following the placement of the retractor that is used by the neurosurgeon to access the cervical vertebral spine, in which an important and large displacement of the structures of the airway can be observed, which can lead to the compression of structures such as the Recurrent Laryngeal Nerve, thus avoiding complications such as dysphonia or aphonia, cough, vocal cord paralysis as the most frequent.

REFERENCES

1. American Society of Anesthesiologists Task Force on Perioperative Blindness. Practice Advisory for perioperative visual loss associated with spine surgery: a report by the American Society of Anesthesiologist Task Force on Perioperative Blindness. Anesthesiology. 2006;104:1319-1328.

2. Cheung JP, Luk KD. Complications of anterior and posterior cervical spine surgery. Asian Spine J. 2016;10:385-400.

3. Morgan EG, Mikhail MS, Murray MJ. Manejo de la vía aérea. Anestesiología clínica. 4a. ed. México, D.F./Bogotá DC: Manual Moderno; 2007, pp. 91-114.

4. Seddighi AF, Nikouei AM, Seddighi AS, Reza ZA, Mahmood TS, Reza SA, et al. Peripheral nerve injury: a review article. International Clinical Neuroscience Journal. 2016;3:1-3.

5. Jung A, Schramm J. How to reduce recurrent laryngeal nerve palsy in anterior cervical spine surgery: a prospective observational study. Neurosurgery. 2010;67:10-15.

6. Vasudeva UK, Jain KM, Shihurkar R, Michael PG, Ramakrishan V. Cuff pressure change during anterior cervical spine surgeries and its effects postoperatively. Karnataka Anaesthesia Journal. 2015;1:60-63.

7. Tan PT, Govindarajulu PA, Massicotte ME, Venkatraghavan L. Vocal cord palsy after anterior cervical spine surgery: a qualitative systematic review. Spine J. 2014;14:1332-1342.

8. Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine. 2000;25:2906-2912.