Positive cuff leak test in a patient with post-extubation stridor after total thyroidectomy. How to deal with it? release_2tgxviudgvbmtjqv3zceyyq3hi

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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