title: Aphonia and dysphagia after gastrectomy.
abstract: A 67-year-old male was referred to our otolaryngological clinic because of aphonia and dysphagia. His voice was breathy and he could not even swallow saliva following a total gastrectomy for gastric carcinoma performed 2 weeks previously. Laryngeal fiberscopy revealed major glottal incompetence when he tried to phonate. However, both vocal folds abducted over the full range during inhalation. The patient could not swallow saliva because of a huge glottal chink, even during phonation. Based on these findings, he was diagnosed as having bilateral incomplete cricoarytenoid dislocation after intubation. The patient underwent speech therapy; within 1 min his vocal fold movement recovered dramatically and he was able to phonate and swallow. There have been few case reports of bilateral cricoarytenoid dislocation, and no effective rehabilitation has been reported. We believe that our method of vocal rehabilitation serves as a useful reference for physicians and surgeons worldwide.
authors.affiliation: Department of Otolaryngology, National Tokyo Medical Center, Tokyo, Japan. ozawahiroyuki@kankakuki.go.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ozawa
authors.forename: Kimura
authors.initials: K
authors.lastname: Satako
authors.forename: Kunio
authors.initials: K
authors.lastname: Mizutari
authors.forename: Takekatsu
authors.initials: T
authors.lastname: Fujimine
authors.forename: Masato
authors.initials: M
authors.lastname: Fujii
authors.forename: Ikeuchi
authors.initials: I
authors.lastname: Syunji
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Matunaga
authors.forename: Koichi
authors.initials: K
authors.lastname: Tsunoda
mesh_terms: D000368:Aged; D001044:Aphonia / Q000209:etiology* / Q000628:therapy; D003413:Cricoid Cartilage / Q000293:injuries*; D003680:Deglutition Disorders / Q000209:etiology* / Q000628:therapy; D003937:Diagnosis, Differential; D005743:Gastrectomy; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007828:Laryngoscopy; D008297:Male; D010699:Phonation / Q000502:physiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013070:Speech Therapy; D013274:Stomach Neoplasms / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy