Fatal asphyxia due to large laryngeal granuloma
DOI:
https://doi.org/10.4322/acr.2024.496Keywords:
Granulation Tissue, Fibrin, Granuloma laryngeal, Polyp, AsphyxiaAbstract
Laryngeal granuloma, vocal process granuloma, or post-intubation granuloma are benign, inflammatory lesions of the arytenoid cartilage vocal process. The etiology of laryngeal granulomas is multifactorial, such as chronic irritation due to endotracheal intubation, vocal cord injury or trauma, and gastroesophageal reflux disease. They can arise postoperatively after mucosal injury due to orotracheal intubation. Clinical manifestations include voice change and dyspnea, which may start one to four months after extubation and may rarely lead to asphyxia. We presented a case of death due to glottic granuloma occurring after a surgical procedure to remove a laryngeal polyp attributed to previous laryngeal injuries by multiple intubations.Downloads
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Tsukamoto M, Taura S, Hitosugi T, Yokoyama T. A case of laryngeal granulomas after oral and maxillofacial surgery with prolonged intubation. Anesth Prog. 2021;68(2):94-7. http://doi.org/10.2344/anpr-68-01-03. PMid:34185856.
Simovic S, Vulovic TS, Stojanovic J, Zivanovic S, Koravovic M. A case report of female patient with laryngeal granuloma. Serb J Exp Clin Res. 2017;18(2):175-7. http://doi.org/10.1515/sjecr-2017-0017.
Hong-Gang D, He-Juan J, Chun-Quan Z, Guo-Kang F. Surgery and proton pump inhibitors for treatment of vocal process granulomas. Eur Arch Otorhinolaryngol. 2013;270(11):2921-6. http://doi.org/10.1007/s00405-013-2527-8. PMid:23677453.
Farwell DG, Belafsky PC, Rees CJ. An endoscopic grading system for vocal process granuloma. J Laryngol Otol. 2008;122(10):1092-5. http://doi.org/10.1017/S0022215108001722. PMid:18312706.
Ramalho LNZ, Martin CCS, Zerbini T. Sudden Death Caused by Fibrovascular esophageal polyp: case report and study review. Am J Forensic Med Pathol. 2010;31(1):103-5. http://doi.org/10.1097/PAF.0b013e3181c6bec2. PMid:20010288.
Tsai SW, Ma YF, Shih LC, Tsou YA, Sung CK. Operative and conservative management of laryngeal contact granuloma: a network analysis and systematic review. J Voice. 2021;35(2):300-6. http://doi.org/10.1016/j.jvoice.2019.08.019. PMid:31628044.
Wu J, Jiang T, Wu Y, Ding L, Dong L. Laryngeal granuloma occurring after surgery for laryngeal cancer treated by surgical removal and immediate post-operative radiotherapy: a case report. Medicine (Baltimore). 2019;98(39):e17345. http://doi.org/10.1097/MD.0000000000017345. PMid:31574876.
Storck C, Brockmann M, Zimmermann E, Nekahm-Heis D, Zorowka PG. Laryngeal granuloma. Aetiology, clinical signs, diagnostic procedures, and treatment. HNO. 2009;57(10):1075-80. http://doi.org/10.1007/s00106-008-1778-y. PMid:19183917.
Rimoli CF, Martins RHG, Catâneo DC, Imamura R, Catâneo AJM. Treatment of post-intubation laryngeal granulomas: systematic review and proportional meta-analysis. Braz J Otorhinolaryngol. 2018 Nov-Dec;84(6):781-9. http://doi.org/10.1016/j.bjorl.2018.03.003. PMid: 29699879.
Bohlender J. Diagnostic and therapeutic pitfalls in benign vocal fold diseases. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2013;13:12. PMid:24403969.
Jin YJ, Lee SJ, Lee WY, Jeong WJ, Ahn SH. Prognostic factors for prediction of follow-up outcome of contact granuloma. Eur Arch Otorhinolaryngol. 2014;271(7):1981-5. http://doi.org/10.1007/s00405-014-2915-8. PMid:24510180.
Martins RH, Dias NH, Santos DC, Fabro AT, Braz JR. Clinical, histological and electron microscopic aspects of vocal fold granulomas. Rev Bras Otorrinolaringol (Engl Ed). 2009;75(1):116-22. http://doi.org/10.1016/S1808-8694(15)30842-9. PMid:19488571.
Kiho L, Byard RW. Acute fatal upper airway obstruction from an occult cavernous hemangioma of the larynx. J Forensic Sci. 2015;60(Suppl 1):S93-6. http://doi.org/10.1111/1556-4029.12587. PMid:25131533.
Tanguay J, Pollanen M. Sudden death by laryngeal polyp: a case report and review of the literature. Forensic Sci Med Pathol. 2009;5(1):17-21. http://doi.org/10.1007/s12024-008-9061-9. PMid:19291432.
Gilbert JD, Byard RW. Laryngeal oncocytic cystadenoma and sudden death. Forensic Sci Med Pathol. 2022;18(4):554-6. http://doi.org/10.1007/s12024-022-00530-0. PMid:36136290.
Stuart E, Armaneous M, Bracken D, Crawford K, Vahabzadeh-Hagh AM. Exuberant intratracheal granuloma. Case Rep Otolaryngol. 2021:6697478. http://doi.org/10.1155/2021/6697478. PMid: 33688444.
Park SY, Choi HS, Yoon JY, et al. Fatal vocal cord granuloma after orthognathic surgery. J Dent Anesth Pain Med. 2018;18(6):375-8. http://doi.org/10.17245/jdapm.2018.18.6.375. PMid:30637348.
Lee DH, Yoon TM, Lee JK, Lim SC. Surgical treatment outcomes of vocal process granuloma after endotracheal intubation. J Craniofac Surg. 2018;29(4):e387-9. http://doi.org/10.1097/SCS.0000000000004389. PMid:29481512.
Devaney KO, Rinaldo A, Ferlito A. Vocal process granuloma of the larynx: recognition, differential diagnosis and treatment. Oral Oncol. 2005;41(7):666-9. http://doi.org/10.1016/j.oraloncology.2004.11.002. PMid:16023983.
Leonard R, Kendall K. Effects of voice therapy on vocal process granuloma: a phonoscopic approach. Am J Otolaryngol. 2005;26(2):101-7. http://doi.org/10.1016/j.amjoto.2004.08.010. PMid:15742262.
Martins RHG, Dias NH, Soares CSP, Gramuglia ACJ. Treatment of laryngeal granulomas. Int Arch Otorhinolaryngol. 2019;23(3):e322-4. http://doi.org/10.1055/s-0039-1688456. PMid:31360253.
Karkos PD, George M, Van Der Veen J, et al. Vocal process granulomas: a systematic review of treatment. Ann Otol Rhinol Laryngol. 2014;123(5):314-20. http://doi.org/10.1177/0003489414525921. PMid:24642585.
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Copyright (c) 2024 Ajay Kumar, Ravi Rautji, Asit Ranjan Mridha, Chittaranjan Behera
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