What is the most likely etiology for a patient diagnosed with left vocal-fold paralysis following a cardiothoracic surgical procedure?

What is the most likely etiology for a patient diagnosed with left vocal-fold paralysis following a cardiothoracic surgical procedure?

• A. An intraoperative CVA in the right pons
• B. Damage to the right recurrent laryngeal nerve
• C. Damage to the left recurrent laryngeal nerve
• D. A left hemispheric stroke

Answer: (C)

The most likely etiology for a patient diagnosed with left vocal-fold paralysis after a cardiothoracic surgical procedure can most accurately be attributed to damage to the left recurrent laryngeal nerve. This nerve is responsible for innervating the left vocal fold and is particularly vulnerable during surgical procedures involving the chest and heart, such as those that may require manipulation or exposure of surrounding structures. In the context of cardiothoracic surgery, the left recurrent laryngeal nerve may be at risk of being stretched or cut due to its course in the thoracic cavity, making it more susceptible to injury during surgical interventions. Damage to this nerve results in paralysis of the corresponding vocal fold, leading to hoarseness, difficulty in phonation, and potential airway issues. While other options discuss events that could affect vocal fold function, they do not directly relate to the typical complications arising from cardiothoracic surgery. For instance, an intraoperative cerebrovascular accident (CVA) could implicate broader neurological deficits but would not specifically cause isolated left vocal fold paralysis. Damage to the right recurrent laryngeal nerve would affect the right vocal fold, while a left hemispheric stroke would not specifically target the vocal mechanism in a localized manner as it relates to

The most likely etiology for a patient diagnosed with left vocal-fold paralysis after a cardiothoracic surgical procedure can most accurately be attributed to damage to the left recurrent laryngeal nerve. This nerve is responsible for innervating the left vocal fold and is particularly vulnerable during surgical procedures involving the chest and heart, such as those that may require manipulation or exposure of surrounding structures.

In the context of cardiothoracic surgery, the left recurrent laryngeal nerve may be at risk of being stretched or cut due to its course in the thoracic cavity, making it more susceptible to injury during surgical interventions. Damage to this nerve results in paralysis of the corresponding vocal fold, leading to hoarseness, difficulty in phonation, and potential airway issues.

While other options discuss events that could affect vocal fold function, they do not directly relate to the typical complications arising from cardiothoracic surgery. For instance, an intraoperative cerebrovascular accident (CVA) could implicate broader neurological deficits but would not specifically cause isolated left vocal fold paralysis. Damage to the right recurrent laryngeal nerve would affect the right vocal fold, while a left hemispheric stroke would not specifically target the vocal mechanism in a localized manner as it relates to