Subcutaneous emphysema

Arytenoid cartilage

Pneumomediastinum

Respiratory distress

Larynx

Surgery

Stridor

Anesthesia

Vocal cord paralysis

Cord

Airway

Alternative medicine

Intubation

Complication

Orotracheal intubation

Recurrent laryngeal nerve

Internal medicine

Paralysis

Palsy

Medicine

Pneumonia

Cuff

Pathology

Thyroid

Revista Española de Anestesiología y Reanimación (English Edition)

Vocal cord paralysis is a rare but severe complication after orotracheal intubation. The most common cause is traumatic, due to compression of the recurrent laryngeal nerve between the orotracheal tube cuff and the thyroid cartilage. Other possible causes are direct damage to the vocal cords during intubation, dislocation of the arytenoid cartilages, or infections, especially viral infections. It is usually due to a recurrent laryngeal nerve neuropraxia, and the course is benign in most patients. We present the case of a man who developed late bilateral vocal cord paralysis after pneumonia complicated with respiratory distress due to SARS-CoV-2 that required orotracheal intubation for 11 days. He presented symptoms of dyspnea 20 days after discharge from hospital with subsequent development of stridor, requiring a tracheostomy. Due to the temporal evolution, a possible contribution of the SARS-CoV-2 infection to the picture is pointed out.

Late bilateral vocal cord palsy following endotracheal intubation due to COVID-19 pneumonia