RLN Injury and Stridor

[Green Grass]

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Was having a discussion with a co-resident today about RLN injury and stridor. I was arguing that the injury must be bilateral to cause stridor. He was saying unilateral paralysis can also cause stridor.

Anyone have insight into this? I've searched online and no definitive source says one versus the other. Thanks!

 

[Scotty_G]

You should not have stridor with unilateral injury. If you do then there is something else/more going on.

 

[Green Grass]

You should not have stridor with unilateral injury. If you do then there is something else/more going on.

My thoughts exactly.

 

[PainDrain]

You need to bag both RLNs for stridor
I had a patient with bilateral RLN after massive neck dissection. She was left intubated (Crna F up story for another time) and on POD 1 extubated with ENT on standby. She was extubated over a cook Cath, developed stridor immediately, reiintubated and then trached in the OR.