Valvular glottic obstruction following extubation

Area of Science:

• Otolaryngology
• Anesthesiology
• Critical Care Medicine

Background:

• Post-extubation airway obstruction is a potential complication following tracheal intubation.
• Glottic and supraglottic pathologies can lead to significant respiratory distress.

Observation:

• A patient developed severe glottic valvular obstruction immediately after extubation.
• The obstruction was attributed to bilateral arytenoid dislocation, likely caused by coughing against the tracheal tube.

Findings:

• The arytenoid dislocation resulted in a critical airway narrowing.
• Spontaneous resolution of the obstruction occurred following a subsequent episode of coughing.

Implications:

• This case highlights an unusual, self-resolving cause of post-extubation airway obstruction.
• Understanding arytenoid dynamics during coughing is crucial for managing airway complications.
• Clinicians should consider arytenoid dislocation in the differential diagnosis of acute post-extubation stridor.