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Paralyzed Lft Vocal Chord after Anesthesia

05/22/2006

Question:

My mother is 77 she had back surgery in Oct. 2005. After the surgery her left vocal chord was paralyzed. At first she was unable to speak. After a few months she started to talk but it was more of a whisper. We went to an ENT who gave my mother many tests and is avoiding any answers. We do know though that her left vocal chord has not responded to any therapy etc. She also has problems swallowing things and chokes! After surgery they told us her body temperature dropped so low they couldn`t bring her to her room. We were told she was being held in intensive care wrapped up with blankets and would be brought to her room when her body temperature rises. When we first saw her much later she was out cold. When she awoke she wasn`t able to talk at all and was a physical mess. It’s been many months and we have been told after many tests, EMG Cat Scan, MRI and a scope of the vocal chords. The ENT told us that her paralysis was caused by injury. He doesn`t seem to know what it is or he won`t tell us as he is affiliated with the hospital that did the surgery! Do you have any ideas why her left vocal chord became paralyzed? We can`t get any answers. Even the surgeon who did back surgery runs away when I try to speak to him. Please help us out! I am really scared my Mom will choke on something and die! Any help would be much appreciated, Thanks, Mr and Mrs grateful!

Answer:

The extensive set of tests that your mother has undergone should have revealed the exact nature of the problem. A laryngeal EMG (electromyogram) would normally tell your doctors what type of injury to the larynx (voicebox) has occurred. It will also help them decide what caused the injury. Although not the only cause of this sort of problem, the kind of paralysis your mother has, along with the swallowing difficulties, may be a rare complication of intubation.

Intubation is the placing of a breathing tube in the windpipe, which is a more or less essential part of the procedure involved in major spine surgery. Stroke is another cause of vocal cord paralysis. And in a certain number of cases, the cause is never found. Because of its rarity, vocal cord injury is not a complication that is often mentioned to the patient in the discussion of risks before surgery. (Sore throat and a bit of hoarseness are quite common but get better quickly). However this complication does unfortunately occur, even when the intubation is done correctly. Some patients will fully recover over time (months). For others, there is improvement but not complete recovery.

Assuming that your mother’s problem is related to the typical kind of injury caused by intubation I would guess there is still potential for your mother to recover further. This recovery will be assisted by proper voice therapy from a specialist. There may also be surgical treatment possibilities, but voice therapy is tried first. It’s hard to understand why your doctors would be avoiding a frank discussion about what has happened and what can be done about it.

My suggestion is to ask politely for another meeting with them. If this fails, you might have more success by contacting somebody in authority at the hospital where the surgery occurred. Many hospitals have a patient representative who handles this kind of issue. You could also write directly to the head of the hospital. I think they would respond promptly and help you to get the answers you need.

For more information:

Go to the Anesthesia health topic.