Unexpected Aphonia: A Rare Complication of the Nasopharyngeal Airway (NPA) and Proposed Design Improvements

Patients with airway foreign bodies typically present with difficulty breathing or stridor. Nasopharyngeal airway (NPA)-related complications are rarely reported. We present a case of a patient with carcinoma of the tongue who underwent nasal intubation for surgery using a flexible bronchoscope. This case is unique because the patient experienced prolonged aphonia without respiratory distress, representing a first-of-its-kind report. We also propose a minor modification to the NPA design to reduce the risk of it slipping into the nasopharynx or larynx.