Prof. Miquel Quer (Barcelona)
Joan P. NHC: 1148562
Male, 76-year-old. Sent for a second opinion.
SARS-Covid-2: INTUBATION - ICU (another Hospital) during 20 days.
After intubation he required tracheotomy due to respiratory problems, and a diagnosis of bilateral vocal fold paralysis was done. In his Hospital, a bilateral cordotomy was proposed.
The patient and the family did not accept it (myopathy and fear of aspirations)
Exploration: vocals folds in medial position but with movements, and probably a posterior synechia. Tracheotomy.
Diagnosis: Posterior glottic stenosis (probably Bogdasarian Type 1 or 2.
Type I. Involves an interarytenoid scar band between the vocal folds that is anterior and separate from the posterior interarytenoid mucosa
Type II. stenosis involves scarring of the mucosa or musculature of the posterior interarytenoid area
Types III unilateral cricoarytenoid joint fixation
Type IV involves bilateral cricoarytenoid joint fixation
The patient and the family only agrees in a microsurgical exploration with section of the probably scar.
(Do not accept cordotomy or arytenoidectomy).