Abstract

 

 

Purpose: To describe the clinical use of the Lo Pro Adult GlideScope Video Laryngoscope (LGVL) for verification and documentation of bilateral recurrent laryngeal nerve (RLN) damage and immediate tracheal reintubation in a patient after thyroid surgery. 

 

Clinical Features: A 80-year-old female patient underwent bilateral thyroid lobectomy. Because both RLNs were at high risk for damage, tracheal extubation was performed using the LGVL to evaluate vocal cord function. Bilateral RLN was verified (and documented as video clip) and the trachea was immediately reintubated. Four days later, the same technique was applied for the second tracheal extubation attempt; vocal cord function had not improved and a tracheotomy was performed for further treatment. Tracheal extubation under videolaryngoscopic view was then used also in other patients with high risk of RLN damage and/or preoperative unilateral vocal cord palsy.   

 

Conclusions and Implications for Clinical Practice: The LGVL provided excellent laryngeal exposure during tracheal extubation and evaluation of vocal cord function (associated with minimal patient discomfort). This technique may be an alternative to postoperative flexible endoscopy-assisted laryngoscopy and airway evaluation after thyroid surgery with RLNs at high risk for damage. 

 

 

Introduction