Abstract / Summary
Abstract Background： Laryngeal mask airway general anesthesia is widely used in clinical anesthesia due to its advantages such as ease of insertion and minimal airway stimulation. However, due to the unique anatomical structure of short-statured adult patients, laryngeal mask placement may increase the risk of vocal cord paralysis. We report a case of left vocal cord paralysis in a short-statured adult (125cm) who underwent gynecological surgery under laryngeal mask airway general anesthesia. Case presentation: A 46-year-old female patient with a height of 125 cm underwent laparoscopic total hysterectomy with bilateral adnexectomy and abdominal drainage under general anesthesia using a size 4 laryngeal mask airway.The procedure included CO2 insufflation for pneumoperitoneum, with the patient positioned in 25°Trendelenburg position.After extubation, the patient reported and developed hoarseness and difficulty speaking. Laryngoscopy revealed paralysis of the left vocal cord.The patient was managed conservatively with voice rest and speech therapy.and showed gradual improvement over the following weeks.Fifty days after discharge, the patient remains hoarse and is currently receiving oral neurotrophic medication and traditional Chinese acupuncture. We will continue to monitor the patient's progress. Conclusion: This case underscores the potential risk of recurrent laryngeal nerve injury in short-statured patients undergoing laparoscopic surgery with a laryngeal mask airway in place. The interplay between patient anatomy, airway device size, and surgical positioning may predispose to nerve compression. Clinicians should maintain a high index of suspicion for this complication, particularly in patients of short stature.