Abstract
We report a case of 55-year-old patient who presented for internal fixation of fractured shaft of humerus, tibia and fibula on the right side. Airway was secured with air- Q size 3.5 at the first attempt. Cuff was inflated with 15ml air in accordance with the manufacturer’s labelled recommendation. After removal, he started feeling discomfort due to inability to speak. Indirect laryngoscopy revealed left vocal cord palsy and decreased movement of left arytenoid. Patient recovered completely in 8 weeks.
Highlights
The Air-Q Intubating Laryngeal Airway (ILA) is a supra-glottic airway used as a primary airway and as an aid for intubation in situations of anticipated or unanticipated difficult airway
Probable cause for nerve injuries associated with LMA is either pressure neuropraxia from the tube or cuff
Zhang J hypothesized that demyelinating neuropraxia resulting from direct mechanical compression contributes to RLN injury associated with LMA
Summary
The Air-Q Intubating Laryngeal Airway (ILA) is a supra-glottic airway used as a primary airway and as an aid for intubation in situations of anticipated or unanticipated difficult airway. We encountered a case of recurrent laryngeal nerve injury following use of air-Q ILA. Our literature search did not reveal any clinical report of vocal cord paralysis caused by air-Q. Airway was secured with air-Q size 3.5 after lubricating with a water-based gel in first attempt.
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