Zellig Gabi, Zwecker Manuel, Weingarden Herold, Wolf Michael
Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
J Spinal Cord Med. 2007;30(5):518-20. doi: 10.1080/10790268.2007.11754586.
BACKGROUND/OBJECTIVE: To report a rare complication of heterotopic ossification of the vocal cords after spinal cord and multiple organ injuries.
Case report.
Acute rehabilitation in the Department of Neurologic Rehabilitation.
A 55-year-old patient sustained spinal cord injury and multitrauma after falling from a height. Approximately 3 months later, after weaning from mechanical ventilation, plugging of the cannula resulted in severe stridor indicating upper airway obstruction. A computed tomography scan showed bilateral vocal cord fixation in a para-median position, with hyperossification of the vocal processes of the arytenoids. Direct laryngoscopy revealed interarytenoid ossification, and sawing through the ossification resulted in remobilization of the vocal cords enabling decannulation.
Heterotopic ossification of the vocal cords was found to be an early complication of acute spinal cord injury and multiple trauma. This rare complication should be considered in the differential diagnosis of patients showing signs of upper airway obstruction.
背景/目的：报告脊髓和多器官损伤后声带异位骨化这一罕见并发症。
病例报告。
神经康复科急性康复治疗。
一名55岁患者从高处坠落，导致脊髓损伤和多处创伤。大约3个月后，在撤机过程中，套管堵塞导致严重喘鸣，提示上气道梗阻。计算机断层扫描显示双侧声带固定于旁正中位，杓状软骨声带突骨质增生。直接喉镜检查发现杓间区骨化，锯开骨化部位后声带恢复活动，得以拔管。
声带异位骨化是急性脊髓损伤和多发创伤的早期并发症。对于出现上气道梗阻迹象的患者，鉴别诊断时应考虑这一罕见并发症。
