From Dysphonia to Danger: Traumatic Laryngeal Complications; A Case Report

Acute dysphonia following blunt head trauma is uncommon but may indicate significant laryngeal injury with potential for progressive airway compromise, particularly in patients receiving anticoagulant therapy.

A 79-year-old patient on direct oral anticoagulant therapy presented to the emergency department with suddenonset dysphonia after a mechanical fall, resulting in a low-occipital head impact without direct neck trauma. Collateral history revealed immediate and pronounced voice change, distinct from baseline. On initial assessment, the patient was hemodynamically stable and exhibited no respiratory distress. Flexible fiberoptic laryngoscopy revealed a large hematoma of the right arytenoid, consistent with blunt cranial trauma in the context of anticoagulation, conferring a substantial risk of progressive upper airway obstruction. The patient was transferred to the intensive care unit for close airway monitoring and anticipatory management.

This case illustrates that isolated arytenoid haematoma may constitute the sole clinical manifestation of significant laryngeal injury in anticoagulated patients and underscores the importance of early laryngoscopic assessment and proactive airway surveillance to avert life-threatening deterioration.