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Right vocal fold paralysis as a result of central venous catheterization

Published online by Cambridge University Press:  29 June 2007

D. P. Martin-Hirsch  and
C. J. R. Newbegin
D. P. Martin-Hirsch*
Affiliation:
Department of Otorhinolaryngology, Huddersfield Royal Infirmary, Huddersfield, Yorkshire, UK
C. J. R. Newbegin
Affiliation:
Department of Otorhinolaryngology, Huddersfield Royal Infirmary, Huddersfield, Yorkshire, UK
*
Mr D. P. Martin-Hirsch, 15 Adwalton Green, Drighlington, Bradford BD11 1B
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Abstract

Invasive peri- and post-operative monitoring is being increasingly utilized, and a corresponding increase of concomitant complications are becoming apparent.

Two cases of complete right vocal fold paralysis are reported as a possible complication of right central venous catheterization. The underlying aetiology of this complication is presumed to be either direct trauma at the time of introduction of the central venous catheter, or by thrombosis and fibrosis around the recurrent laryngeal or vagus nerve. It is suggested that multiple attempts at cannulation and leaving the central line in situ for long periods increases the risk of this complication.

When the integrity of the left recurrent laryngeal nerve or vagus is jeopardized or must be sacrificed during surgery, it is suggested that ipsilateral central lines are inserted to minimize the risk of bilateral vocal fold paralysis.

Cases of vocal fold paralysis secondary to central line insertion should be followed expectantly and surgical intervention only be considered after 12 months review.

Keywords

Vocal fold paralysisCatheterizationcentral venous
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 11 , November 1995 , pp. 1107 - 1108
Copyright
Copyright © JLO (1984) Limited 1995

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