2023 Volume 43 Issue 4 Pages 302-306
A 65-year-old woman with severe COVID-19 was treated with tracheal intubation and prone positioning therapy. Oxygenation improved and extubation was attempted, but the patient was reintubated due to stridor and inadequate sputum expectoration. Another attempt was made to extubate the patient 5 days later, but the patient was reintubated due to dysphonia and insufficient sputum expectoration. A tracheostomy was performed as extubation was deemed difficult in the short term. The tracheal cannula was removed on day 17 post-tracheostomy, but dyspnea developed, and the tracheal cannula was reinserted. Laryngoscopy and CT scan of the neck by an otolaryngologist revealed that the patient had arytenoid cartilage dislocation and bilateral laryngeal paralysis. Laryngeal function should be evaluated with attention to arytenoid cartilage dislocation and bilateral laryngeal paralysis during prolonged intubation or prone positioning, which places stress on the larynx.
