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A 60-year-old male undergoes a C6-7 ACDF for intractable C7 radiculopathy via a left-sided approach. He previously had the same procedure performed at a more cephalad level through a left-sided approach that left him with hoarseness that resolved with time. Video V labels the anatomic landmark then shows a technique step that is part of the routine dissection for this procedure. Excessive Bovie cautery during this technical step in the lateral muscles that are being retracted would put the patient at risk for which of the following symptoms.
Change in the pitch of the voice, vocal fatigue, and difficulty with explosive sounds
Deviation of the tounge to the ipsilateral side
Ipsilateral pupillary miosis, enophthalmos, and loss of ciliospinal reflex
Paresis of the ipsilateral strap musculature
Dural perforation and CSF leak
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A myelopathic patient undergoes anterior cervical diskectomy and fusion through a left sided approach. Facial asymmetry is noticed postoperatively in the recovery room. A clinical photo is shown in Figure A. What additional finding would likely be found on physical exam?
Pupillary dilation and hyperhidrosis on the patient's right side
Pupillary dilation and hyperhidrosis on the patient's left side
Pupillary constriction and hyperhidrosis on the patient's right side
Pupillary constriction and anhidrosis on the patient's left side
Pupillary constriction and anhidrosis on the patient's right side
A 53-year-old female is 8 hours status post the procedure seen in Figure A. You are called to the room by the nurse who reports the patient is having difficulty breathing. On arrival, you note that the patient has stridor on inspiration and a firm mass under the incision. What is the most likely cause of her respiratory compromise?
Vocal cord paralysis