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Contralateral Recurrent Laryngeal Nerve Palsy In Revision Anterior Cervical Discectomy And Fusion (Acdf): A Cautionary Tale, Chenghan Wu, Eugene Wei Ren Yang, Kelvin Kah Ho Lor

BioMedicine

Revision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelopathy, and in whom pre-operative laryngoscopic evaluation had excluded a pre-existing occult RLNP. Scarring around the recurrent laryngeal nerve at the previous surgical site may have rendered it less mobile, resulting in it being more susceptible to compression from an inflated endotracheal tube (ETT) cuff or traction from surgical retractors. This case illustrates that …