Efficacy of Voice Therapy in Patient with Arytenoid Dislocation as a Complication of Tracheal Intubation

Abstract

Introduction: Tracheal intubation is the placement of a flexible plastic tube into the trachea to maintain an open airway or to serve as a conduit through which certain drugs are administered. Arytenoid dislocation is one of the rare reported complications of tracheal intubation. Decreased volume and breathiness are the most common voice symptoms. Need for the Study: There is lack of prospective and systemic study of the incidence of arytenoid dislocation and efficacy of voice therapy in such cases. Aim of the Study: Present study was carried out to find out the efficacy of voice therapy as independent management option in persons with arytenoid dislocation as a consequence of tracheal intubation. Materials and Methods: The study was based on a case study of a 37 year old male patient who reported to C U Shah Medical College and Hospital, Surendranagar with complaint of breathy and soft voice quality post laparotomy as a consequence of intubation. ENT examination revealed both vocal cord bowing with ? subclinical sublaxtition of arytenoid. Pre and post voice therapy assessment was done using GRBAS scale (for perceptual analysis), Praat software (for acoustical analysis) and VHI scale (for measuring the effect of voice disorder on the quality of life). Voice therapy was given for two months and pre and post findings were compared. Results: Significant improvement was observed on all the measures. Conclusion: Although arytenoid cartilage dislocation following the use of intubation is a rare event, it is important to be aware of its occurrence and to conduct diagnostic tests as early as possible in case of persistent hoarseness. Voice therapy may be used as an adjunct to phonosurgery or independently an effective intervention.