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Breathing Tube Injury (1 of 4)

Some weeks after a 3-day intubation for a nonorganic breathing problem, some ongoing (and different) breathing symptoms are caused by a synechiae that will not permit full abduction of the vocal cords. The * allows comparison with photo 2.

Breathing Tube Injury (2 of 4)

Extremely close visualization of the post-intubation synechiae (* to orient with photo 1). Note the opening posterior to the synechiae indicated by the arrows. This makes it less likely that there is a concomitant ankylosis (fixation) of either cricoarytenoid joint.

Breathing Tube Injury (3 of 4)

Several months after surgical release of the synechiae, notice that abduction of the vocal cords again makes a normal, wide-open “v.” Compare with photo 1 to see this clearly.

Breathing Tube Injury (4 of 4)

Closer visualization of the posterior commissure shows evidence of scar at the left base of the synechia. This could be easily overlooked if the patient’s history were not known.

 

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