https://orcid.org/0000-0001-6869-537X
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Abstract
Arytenoid cartilage necrosis (ACN) is a life-threatening laryngeal complication that develops after prolonged endotracheal intubation (PEI). We describe a case of ACN due to PEI that was treated conservatively with close endoscopic follow-up. A 46-year-old man required 4 days of postoperative endotracheal intubation after surgery for Stanford A acute aortic dissection. Five days post-extubation, he presented with hoarseness and wheezing. Endoscopy and computed tomography findings confirmed ACN. We used conservative treatment to avoid a tracheostomy because the patient had no dyspnoea. During healing, vocal cord mobility changed per the extent of cicatrisation and adhesion, and glottic closure due to inter arytenoid adhesion was possible. The bilateral vocal cords were eventually fixed in a paramedian position. The patient could phonate via ventricular band mobility without aspiration or dyspnoea. Given the possibility of variable laryngeal findings, careful endoscopic evaluations may be needed until wound healing completes to avoid sudden suffocation after PEI.
Ethical statement
This study has not been published or presented elsewhere in part or in entirety. This material is the authors’ original work.
Patient consent
The patient described in the study provided written informed consent for the publication of this case report, and the study protocol was approved by the Ethics Committee of Nara Medical University Hospital (the proposal number was 3300).
Disclosure statement
The authors report no conflict of interest.
Data availability statement
The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.