Case ReportBilateral vocal cord palsy after total thyroidectomy-A new treatment-Case reports

•The mean NGA during inspiration in patients with dyspnea was less than that in patients without.•The mean age of patients with dyspnea was greater than that of patients without.•Dyspnea that occurred at 0-8 days post operation recovered within 3-17 days after BiPAP.

IntroductionDyspnea due to bilateral vocal cord palsy after total thyroidectomy (BVCPATT) is a life-threatening complication; nevertheless, we try to avoid tracheotomy.MethodsUsing normalized glottal area (NGA), we retrospectively studied 14 patients with BVCPATT. Nine patients without dyspnea were treated conservatively, while five with dyspnea received immediate bilevel positive air-way pressure (BiPAP) treatment. Both right and left recurrent nerves were grossly intact during surgery.ResultsThe mean NGA during inspiration of five patients with dyspnea was less than that of nine patients without (6.21 ± 1.57 (mean ± standard deviation) vs. 20.5 ± 9.5; p = 0.001). The mean age of patients with dyspnea was more than that of patients without (61.6 ± 15.6 vs. 38 ± 10.2; p = 0.007). Five patients with dyspnea that occurred at 0-8 days post operation recovered within 3-17 days after BiPAP.ConclusionDyspnea occurred in patients with BVCPATT who were relatively older. The mean NGA during inspiration in patients with dyspnea was less than that in patients without. BiPAP might be a new treatment for dyspnea.