Positive cuff leak test in a patient with post-extubation stridor after total thyroidectomy. How to deal with it?

Authors

  • Liliana Borges Paulo Centro Hospitalar Universitário de Coimbra
  • Eva Silva Department of Anesthesiology, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
  • Sara Rêgo Department of Anesthesiology, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
  • Maria Helena Lima Department of Anesthesiology, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
  • Cláudia Carreira Department of Anesthesiology, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
  • Gisela Costa Department of Anesthesiology, Coimbra Hospital and Universitary Centre, Coimbra, Portugal

DOI:

https://doi.org/10.25751/rspa.15269

Abstract

Thyroid surgery (TS) is the most frequent cause of bilateral vocal cords (VC) palsy. This emergency is rare and can cause post-extubation stridor (PES) by recurrent laryngeal nerve (RLN) section.

We report a case of a patient proposed to TS. In the end of an uneventful surgery, qualitative cuff leak test (CLT) was positive. Neverthless, patient was extubated. She started PES two minutes later and was reintubated. Direct laryngoscopy demonstrated adduction of VC and, because she maintained immobility of the glottis, she was tracheostomized for six months.

Qualitative and quantitative CLT is a costless easy method that allows us to evaluate the possibility of RLN lesion prior to extubation. Very little is known about the CLT utility on TS, about its importance in high-risk patients and if extubation can be wheighted based on its result.

A CLT protocol with a datasheet were created and adapted to TS in our department.

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Published

2018-12-15

How to Cite

Paulo, L. B., Silva, E., Rêgo, S., Lima, M. H., Carreira, C., & Costa, G. (2018). Positive cuff leak test in a patient with post-extubation stridor after total thyroidectomy. How to deal with it?. Journal of the Portuguese Society of Anesthesiology, 27(4), 108–111. https://doi.org/10.25751/rspa.15269

Issue

Vol. 27 No. 4 (2018): Revista da Sociedade Portuguesa de Anestesiologia

Section

Case Report

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