Kashima's Procedure
Journal Title: Medpulse International Journal of ENT - Year 2019, Vol 10, Issue 1
Abstract
Background: Vocal fold paralysis refers to reduced or absent function of the vagus nerve or its distal branch, the recurrent laryngeal nerve. Kashima’s procedure is a lateralization procedure of the vocal cords performed for cordotomy using laser introduced by Kashima in 1989. Case Report: 50 y/o female - o/c/o Rt hemithyroidectomy with dyspnea (NYHA 2). Lt vocal cord palsy, Rt cocal cord sluggishly mobile. RS - Inspiratory stridor +Preoperatively, the patient in sitting position pharynx was anaesthetised with10./. Lignocaine spray and 2ml of 4./. Lignocaine nebulisation. Patient was induced with Inj.Propofol 50mg (+30mg+20mg+20mg) (in titrated doses) and Inj.Atracurium 25mg iv. Patient was intubated orally using a cuffed microlaryngeal tube number 5. Intraoperatively, patient was vitally stable. Analgesia was provided in the form of top ups of Inj.Fentanyl 20ug iv. Reversal given post -op and pt. extubated smoothly. Discussion: A microlaryngeal tube was used to secure the airway and patient was ventilated using a closed-circuit ventilator system. The advantage being smooth maintenance of airway throughout surgery and ability to provide oxygen at low concentrations. Anaesthesia was maintained using oxygen-air mixture with isoflurane (non-inflammable agent).
Authors and Affiliations
Vidisha S Barua, Pradnya Kulkarni
Keywords
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