tailieunhanh - Báo cáo y học: " Recurrent laryngeal nerve palsy complicating subclavian line insertion: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Recurrent laryngeal nerve palsy complicating subclavian line insertion: a case report | JOURNAL OF MEDICAL Sr CASE REPORTS Open Access Case report Recurrent laryngeal nerve palsy complicating subclavian line insertion a case report Jonathan M Fishman Address Department of Otolaryngology The John Radcliffe Hospital University of Oxford Oxford OX3 9DU UK Email jfishman@ Received 4 November 2008 Accepted 26 February 2009 Published 8 September 2009 Journal ofMedical Case Reports 2009 3 9034 doi 1752-1947-3-9034 This article is available from http jmedicalcasereports article view 9034 2009 Fishman licensee Cases Network Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Introduction Although recurrent laryngeal nerve injury has been described following central venous access via the jugular route it has not previously been reported following access via the subclavian route. Case presentation A 63-year-old man presented with acute dysphonia immediately after insertion of a Hickman line via the subclavian route. Flexible laryngoscopy revealed a left vocal fold palsy. A computed tomography scan from the skull base to the thoracic inlet showed no obvious abnormality other than an abducted left vocal cord. The timing of the events and the computed tomography scan results strongly support the conclusion that the left recurrent laryngeal nerve was injured during insertion of the Hickman line resulting in a left adductor vocal cord palsy. Conclusion This case illustrates an unusual example of iatrogenic injury to the recurrent laryngeal nerve. It is important to recognize the possibility that such injuries may occur in order to prevent them. Introduction Neurological injuries to the cervical plexus brachial plexus vagus phrenic and recurrent laryngeal nerves are recognized complications of .