Abstract
Feeding via a nasogastric tube is a commonly available and convenient procedure, and is thus acceptable for various conditions. However, it has recently been reported that prolonged insertion of a naso-gastric feeding tube might result in serious complications. Here, we report a case of supraglottic stenosis induced by prolonged insertion of a nasogastric feeding tube.
A 53-year-old woman who had undergone a clipping operation for an aneurysm of the vertebra artery—posterior inferior cerebellar artery on the left side and a tracheotomy complained of severe dysphagia caused by postoperative IX, X, XI cranial palalysis on her left side. Thus, feeding via a nasogastric tube which was inserted to the left pyriform sinus, perfomed to remain her nuturitional condition. Subsequently, she come down with bacterial meningitis, leading to a loss of consciousness. The use of the nasogastric tube feeding had to be prolonged for three months. After a recovery in her general condition, when the tracheal stoma should have been closed, she complained of inspiratory stridor and dyspnea. Fiberscopic observation revealed that the mucosal membrane of the arytenoid on the left side, with which the nasogastric tube was incontact, was severly swollen. The lesion extended down into the glottic space, causing the inspiratory stridor. When, the tube was taken out and conservative theory performed for three weeks, these symptoms and findings did not improve. Subsequently, we performed a resection of the swelling lesion in the left arytenoid mucosa under laryngomicrosergery with YAG-LASER. After this operation, her symptonms improved completely, and the tracheal stoma could be closed.
