My mother is 77 she had back surgery in Oct. 2005. After the surgery her left vocal cord was paralyzed. At first she was unable to speak. After a few months she started to talk but it was more of a whisper. We went to an ENT who gave my mother many tests and is avoiding any answers. We do know though that her left vocal cord has not responded to any therapy etc. She also has problems swallowing things and chokes! After surgery they told us her body temperature dropped so low they couldn`t bring her to her room. We were told she was being held in intensive care wrapped up with blankets and would be brought to her room when her body temperature rises. When we first saw her much later she was out cold. When she awoke she wasn`t able to talk at all and was a physical mess. Itﾒs been many months and we have been told after many tests, EMG Cat Scan, MRI and a scope of the vocal cords. The ENT told us that her paralysis was caused by injury. He doesn`t seem to know what it is or he won`t tell us as he is affiliated with the hospital that did the surgery! Do you have any ideas why her left vocal cord became paralyzed? We can`t get any answers. Even the surgeon who did back surgery runs away when I try to speak to him. Please help us out! I am really scared my Mom will choke on something and die! Any help would be much appreciated, Thanks, Mr and Mrs grateful! 

The extensive set of tests that your mother has undergone should have revealed the exact nature of the problem. A laryngeal EMG (electromyogram) would normally tell your doctors what type of injury to the larynx (voicebox) has occurred. It will also help them decide what caused the injury. Although not the only cause of this sort of problem, the kind of paralysis your mother has, along with the swallowing difficulties, may be a rare complication of intubation. Intubation is the placing of a breathing tube in the windpipe, which is a more or less essential part of the procedure involved in major spine surgery. Stroke is another cause of vocal cord paralysis. And in a certain number of cases, the cause is never found. Because of its rarity, vocal cord injury is not a complication that is often mentioned to the patient in the discussion of risks before surgery. (Sore throat and a bit of hoarseness are quite common but get better quickly). However this complication does unfortunately occur, even when the intubation is done correctly. Some patients will fully recover over time (months). For others, there is improvement but not complete recovery. Assuming that your mother's problem is related to the typical kind of injury caused by intubation I would guess there is still potential for your mother to recover further. This recovery will be assisted by proper voice therapy from a specialist. There may also be surgical treatment possibilities, but voice therapy is tried first. It's hard to understand why your doctors would be avoiding a frank discussion about what has happened and what can be done about it. My suggestion is to ask politely for another meeting with them. If this fails, you might have more success by contacting somebody in authority at the hospital where the surgery occurred. Many hospitals have a patient representative who handles this kind of issue. You could also write directly to the head of the hospital. I think they would respond promptly and help you to get the answers you need. 

I had laparoscopic surgery 5 weeks ago for a hernia. Since that time, I had some minor nausea with severe hoarseness in my voice with a sore throat. The surgery itself went fine. The voice hoarseness and sore throat is still there and now I have vomited a small amount of blood 1 time. I had not eaten that day and the blood was pink with saliva only. Could this be something caused from the anesthesia during surgery? I am not taking any medications at this time. Thank you for any help. 

ﾠA sore throat after general anesthesia is not uncommon, occurring about 20-30% of the time. In most cases it is mild, and gets better without treatment over a couple of days. Similarly, nausea after general anesthesia is quite common, especially if you are young, female, have had postoperative nausea or motion sickness before, a long anesthetic, and if you have had certain types of surgery, such as breast operations, eye or ear procedures, shoulder operations and others. It is certainly unusual that you would have your sore throat, or nausea, 5 weeks after the anesthetic. Coughing or vomiting blood is quite an alarming symptom so I'm sure you're worried. It doesn't necessarily represent something nasty but should definitely be investigated. Recent studies have shown that even when the intubation goes very smoothly, the passage of the breathing tube into the larynx (voice-box) and through the vocal cords often causes minor trauma - bruising. In rare cases, the small cartilages of the larynx can be significantly damaged, and this can take quite a long time to recover. The main symptom in this case is hoarseness. More serious injury to the voice box, or to the nerves that supply it, is also possible. Very rarely, the sore throat can be a sign of something even more ominous - a tear in the lining of the throat that if extensive can lead to severe infection, called mediastinitis. This can happen if the intubation (insertion of breathing tube) is traumatic for some reason, and if the lining of the throat is abnormally thin (e.g. elderly people, or those taking steroids) but this will usually happen over the few days immediately after the operation, not 5 weeks later. It is possible that your larynx was injured during the intubation or the course of the anesthetic. For this reason you should call your doctor and ask for a referral to an ENT (Ear, Nose and Throat) doctor who can do a thorough examination of your throat. It would also be a good idea if possible to make contact with your anesthesiologist. He or she will be keen to know that something has happened that might be related to anesthesia care and I imagine will be interested in helping you get diagnosed and appropriately treated. 

Two years ago I had a kidney stone blasted while under anesthesia. It was almost a two hour procedure. After waking up my voice was slightly hoarse, and became gradually hoarser over time. I was also unable to project my voice. I went to many doctors and but none of them was able to give me a diagnosis, until I was finally told by an acquaintance (not a doctor) that I should go see a VOICE doctor, (gee, I wonder why none of the many doctors I went to see, ever recommended that to me before?) Anyway, I finally got my diagnosis, I had a dislocated vocal cord and the some nerve damage. Because it took a year to get a diagnosis and because there was nerve damage, they were not going to be able to just push it back into it right location. I did have one procedure done where the were able to inject some kind of paste into the vocal chord to plump it up. That did improve my speaking voice somewhat. I am now able to talk in a soft voice, but I still can`t project or speak in a room where there is any kind of background noise, which is all public places. My question to you is: Is this a recognized risk, that I must have signed my name to before the procedure, or do you think it could be an incapable anesthesiologist? 

Vocal cord injury is a recognized risk of tracheal (windpipe) intubation, which is a common, though not always essential, component of general anesthesia. Mild laryngeal (voice box) injury is surprisingly frequent after tracheal intubation. Examination of the larynx will show bruising and/or swelling. More serious injury, such as vocal cord dislocation, is much less common. Temporary hoarseness is the main symptom of mild laryngeal injury and this almost always gets better without treatment. 

I had surgery in July and after the anesthesia they said my throat would be dry and sore for a couple of days and that it was normal. It is now November and my throat is still dry and it feels like there is a bump or flap in my throat that makes it hard to swallow. I had called the anesthesiologist about a week after to tell him my symptoms and he said it was nothing that he would`ve done, and had me go to my family doctor to get checked. I did and they said my throat looked red and that I had a infection and gave me an antibiotic. The feeling has never gone away and I get headaches a lot now too because of the dryness. I drink lots of water but it stays dry. It does not hurt a lot, but it is a nuisance. What could be causing this? I was thinking it was from the tube they inserted in my throat for anesthesia during my surgery. Can this be a complication from that? 

Sore throat after anesthesia is quite common. In some cases it is due to the intubation - that is the insertion of a plastic breathing tube or airway. The gases that are breathed are pretty dry so that may also contribute to the soreness. These symptoms usually go away within a couple of days. Symptoms that persist for 4 months, as yours have done, suggest that something else is going on. Dry mouth can be caused by salivary gland disorders, of which there are several causes, as well as by medications. The bump or flap in your throat could be just that, or perhaps it is related the dryness. Whether there is something abnormal in your throat, and what it is, can only be determined by an examination. I suggest you be seen by an ENT (ear, nose and throat) specialist who can perform such an examination. Salivary gland problems are also in the territory of the ENT specialists. 

I had a spinal with my c-section. I recently found out I have paralysis of my right vocal cords. My doctor had me get a ct scan of my head neck and chest which revealed paralysis of my right diaphragm. I can`t get in to see a lung specialist for another 2 months. I am wondering could the spinal have caused this and what other tests could I have done to regain proper function. Will this be permanent? 

The nerves that supply the vocal cords come from the vagus - the tenth cranial nerve. The phrenic nerve supplies the diaphragm. I think it is most unlikely that the spinal anesthesia would have caused paralysis of your vocal cords and diaphragm. A rare complication of spinal anesthesia is cranial nerve palsy, affecting the third, fourth or sixth cranial nerves, but paralysis of the vagus nerve or phrenic nerve has not, to my knowledge, ever been described. The cranial nerves are nerves that emerge from the lower part of the brain. The third, fourth and sixth cranial nerves pass to the eye muscles, controlling the movement of the eyes. Nerve problems caused by spinal anesthesia usually recover over time. 

What is more likely is that there may be a problem in a single area of the right lung or the mediastinum - the area in the center of the chest - that is affecting both the phrenic and vagus nerves. You should make sure that you follow up with your doctors as soon as possible because of the possibility that a serious disease is responsible for the problems you have described. 

How common is vocal cord paralysis post op? 

Minor trauma to the vocal cords, resulting in temporary hoarseness, is a relatively common complication of endotracheal intubation. Vocal cord paralysis is fortunately rare (much less than 1%). All complications of intubation are more likely to occur with prolonged intubation as in the case of critically ill patients in intensive care units. The left vocal cord is more often involved than the right, although cases affecting both sides can occur. Patients usually complain of hoarseness, but may develop airway obstruction which is obviously far more serious. Apart from duration of intubation, other factors may increase the risk, such as use of a large endotracheal tube, excessive pressure in the inflatable cuff used to seal the airway, or placement of the tube cuff close the vocal cords. The cause of vocal cord paralysis is thought to be compression of the recurrent laryngeal nerve by the endotracheal tube cuff as it enters the larynx between the cricoid and arytenoid cartilages . ENT doctors can diagnose the problem with a special test called electromyography and with direct laryngoscopy (visual examination of the vocal cords). In most cases, the vocal cords will recover, on average taking about 3 months.