Injury, typically to the posterior part of both vocal cords, caused by an endotracheal tube 1. An endotracheal tube may be used briefly during general anesthesia for surgery, but may be in place for much longer in persons suffering respiratory failure or neurological injury. When severe, the hallmark vocal phenomenology of intubation injury is breathy-pressed phonation.
Breathing Tube Injury may Correlate with Side of Mouth
Breathing Tube Injury, not Vocal Cord Paralysis
Breathing Tube Injury—A Rare Complication of Intubation for General Anesthesia
Conclusion: While we try to explain abnormality due to one cause, here, the patient has a mucosal injury and paresis of right TA and LCA muscles, which can also follow intubation. This explains why the initial postop voice was so weak and whispery, and also the rapid partial improvement. This voice will likely continue to improve and be very functional as a speaking voice. Fortunately, this person is not a singer, as clarity especially in upper notes, will likely be remain impaired even after full recovery.
Breathing Tube Injury: Synechiae
“Tattoo” of blood after detachment of intubation granuloma
Intubation injury audio with photos:
Voice sample of a patient with a cricoartyenoid joint intubation injury (see this patient’s photos just below):
Intubation Injury Causing Partially Frozen Cricoarytenoid Joints
Forcing the Larynx to Give Up Its (Paresis and Intubation Injury) Secrets
Intubation Injury, Including A Subglottic Synechia
Vocal Cord “Tear” and Granuloma
Injured Adult Larynx from Intubation In Infancy
Intubation Injury to Voice, Airway, from Decades Ago
Injury at Two Levels from Breathing Tube-Particularly Clear
Subglottic Granulation and Curving Airstream
Double Whammy: Intubation Injury + Glottic Furrows
Sometimes You DO Remove Granulation to Avoid Tracheotomy
Who Knew…? Many Such Injuries Are Never Found
A Strapping Young Man Whose Larynx Was Injured As A 1-lb Preemie!
An “Inner Voice” Problem Viewed As An End-Organ Problem
Intubation Scar With Pseudo-Polyp
- Bastian RW, Richardson BE. Postintubation phonatory insufficiency: an elusive diagnosis. Otolaryngol Head and Neck Surg. 2001; 124(6): 625-33.[↩]