Two cases of postoperative bilateral recurrent laryngeal nerve paralysis.

Two cases of bilateral recurrent laryngeal nerve paralysis due to surgery of the neck were reported. In case 1, the paralysis occurred after surgery of the parathyroid glands. Improvement began at 48th day after surgery, and it took 4 months to get complete recovery. In the meantime, EMG of the laryngeal muscles was performed, but did not provide valuable information to judge the prognosis of the paralysis. A possible social problem had been anticipated between the patient and the hospital, but fortunately the paralysis recovered. In case 2, the paralysis occurred after surgery of the thyroid gland. Recovery started unilaterally 92 days after surgery, but complete paralysis remained even after 8 months on the other side. The prominent symptom of the patients in both cases was severe hoarseness. They did not complain of dyspnea. It should be stressed that particular attention is required pre- and post-operatively so that the patient understands fully the underlying problem. A long time follow-up may be necessary, since it sometimes takes long time to recover from paralysis.