Ipsilateral vocal cord paralysis following central line placement

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We present an unusual complication of recurrent laryngeal nerve palsy, leading to right vocal fold paralysis, following insertion of a right internal jugular tunnelled dialysis catheter” Koduri et al (2019).

Abstract:

BACKGROUND: Central venous catheters are extensively used in critical care units and in dialysis centres to gain access to the blood stream for the purpose of invasive monitoring, drug administration, parenteral nutrition and to perform renal replacement therapy. One of the common areas of central venous catheter insertion is right internal jugular vein due to its anatomical continuity with the superior vena cava. The complication rates of central venous catheter insertion can be more than 15%, including early and late complications.

CASE REPORT: We present an unusual complication of recurrent laryngeal nerve palsy, leading to right vocal fold paralysis, following insertion of a right internal jugular tunnelled dialysis catheter. The vocal fold paralysis improved over next 8 months with conservative management alone.

CONCLUSION: This case illustrates an unusual complication of central venous catheter insertion and the importance of recognizing the possibility of such complications, to prevent them from happening and also to manage them appropriately.

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Reference:

Koduri, S., Ng, A.K.H., Roy, D. and Wong, E.C.K. (2019) Ipsilateral vocal fold paralysis: An unusual complication of internal jugular tunnelled dialysis catheter insertion. The Journal of Vascular Access. June 24th. doi: 10.1177/1129729819856967. .

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