Abstract
Background Unilateral or bilateral vocal cord (VC) paralysis following atraumatic intubation is extremely rare and has been reported even in the absence of any predisposing factors. Occurrence of such a complication is disconcerting to the clinician as well as the patient alike. Case A 42-year-old man suffering from cryptogenic cirrhosis of the liver, who underwent a deceased donor liver transplant, developed left-sided VC palsy postoperatively. No apparent cause was found and his symptoms recovered after conservative management. It was concluded that the patient possibly had recurrent laryngeal nerve neuropraxia due to compression by the endotracheal tube cuff. Conclusion We would like to briefly describe the case, possible mechanisms for VC palsy following intubation, its benign course and the possible role of pre-existing laryngeal deformity, with the aim of enhancing the awareness among anaesthesiologists about this rare complication. Although not unique to liver transplant surgeries, the relatively longer perioperative period of ventilation in such surgeries may accentuate any pressure effects.
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