J Dent Anesth Pain Med.  2018 Dec;18(6):375-378. 10.17245/jdapm.2018.18.6.375.

Fatal vocal cord granuloma after orthognathic surgery

• Park SY
• Choi HS
• Yoon JY
• Kim EJ
• Yoon JU
• Kim HY
• Ahn JH

• KMID: 2430215
• DOI: http://doi.org/10.17245/jdapm.2018.18.6.375

Abstract

Endotracheal intubation is commonly associated with laryngeal injury that often resolves spontaneously without any complication. However, stenosis or granulomatous lesions are generally found on the tracheal wall or vocal process at the tube cuff level, caused by excessive cuff pressure. We present a case of fatal vocal cord granuloma leading to dyspnea following orthognathic surgery and sustained intubation for 14 hours.

Keyword

Granuloma; Intubation; Trauma; Vocal Cord

MeSH Terms

Constriction, Pathologic
Dyspnea
Granuloma*
Intubation
Intubation, Intratracheal
Orthognathic Surgery*
Vocal Cords*

Figure

• 

  Fig. 1 Three months postoperatively, the right vocal cord granuloma is observed in outpatient laryngoscopy.

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  Fig. 2 Granuloma has become larger and blocked more than half of the vocal cord, five months postoperatively.

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  Fig. 3 On arrival at the emergency room, most of the vocal cord seems to be blocked by the mass (a), with bleeding tendency (b).

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  Fig. 4 Laryngeal examination does not reveal any heteroplasia in the vocal cords, three months after granuloma removal surgery.

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