Bilateral Vocal Cord Palsy During Carotid Endarterectomy Under Cervical Plexus Block

Abstract

In Brief We describe a case of vocal cord palsy leading to respiratory obstruction during carotid endarterectomy under cervical plexus block in a patient who had preexisting contralateral vocal cord paralysis subsequent to a previous thyroidectomy. The patient required immediate tracheal intubation and subsequent tracheostomy to maintain the airway postoperatively. Care must be given to avoid contralateral vocal cord paralysis in the presence of a preexisting vocal cord palsy. IMPLICATIONS: Abrupt onset of vocal cord adduction during awake carotid endarterectomy may cause acute respiratory obstruction in the presence of prior contralateral vocal cord palsy.