Vocal cord paralysis after craniotomy [Krani̇otomi̇ sonrasi vokal kord parali̇zi̇si̇]

59 years old,88 kg weight patient with asa grade iii,was planned craniotomy because of right corner serebellopontin tumor. preoperative evaluation of patient,had hypertension for 13 years and diabetes for 5 years and were using ace inhibitors and oral antidiabetic. preoperative evaluation of blood sugar was 186 mg dl-1,blood pressure (bp) 180/115 mmhg,respectively. anesthesia induction was performed using thiopental intravenously (i.v.) (5 mg kg-1). isoflurane was used for the maintenance of anesthesia. after the mask ventilation the patient was intubated. the patient's head fixed with pin holder. remifentanil (0.1-1 mg kg-1 h-1) infusion and gliserol trinitrat (0.1-1 mg kg -1 h-1) infusion were administered. blood pressure and pulse were within normal limits. operation lasted for 7 hours 30 min. any hemodynamic and respiratory complications were not observed. immediately after surgery hoarseness and respiratory distress developed. vocal cord paralysis (vcp) was determined. urgent tracheostomy was performed and 7 days later the patient's tracheostomy closure performed. patient was discharged after 10 days and 3 months after the voice tone has improved.