氣管插管後延遲性單側聲帶運動不良及肉芽腫

Adult patients who undergo endotracheal intubation occasionally suffer laryngeal abnormalities. A 57-year-old female housewife had received three days ICU intubation due to septic shock with multiple organ failure. A laryngeal examination did not show any abnormal findings at one week after extubation. However, one month later, she was bothered by husky hoarseness and easy vocal fatigue. A physical examination showed the presence of left vocal fold immobility and granuloma. Two months of conservative treatment failed to cure the symptoms and therefore microlaryngeal surgery was recommended to excise the vocal granuloma. After this, the left vocal fold immobility was found to have remitted after two months of postoperative recovery. The following six months was uneventful, and there has been no recurrence of vocal palsy or granuloma. Therefore, although no laryngeal symptom or abnormality were found after extubation, it would seem that delayed vocal fold immobility and granuloma may still occur at up to one month after tube removal among patients who have undergone ICU intubation. Therefore close follow up is recommended for all patients who undergo intubation.