Thursday, May 23, 2013
During an intubation my voicebox was injured. It is now 10 weeks and my voice is very horse and it takes alot of energy to speak. I went to a throat speaciaist and he prescribed a seven day dose of steriods and an anti acid. That did not work. I than took another dose of steriods. For a couple of days after the medication, my voice was a little stronger, but it did not last. I am scheduled to see another throat specialist at the end of April, but was wondering what your opinion is. How long does it usually take to heal this type of injury. When should I start to worry (I`m already worried). What are the chances of my voice not coming back?
There is no doubt that intubation can injure the voicebox (larynx). In fact minor injuries that occur during routine, careful, apprarently uncomplicated intubation are surprisingly common, based on evidence from studies where the larynx is examined with special scopes after intubation. The larynx appears bruised, with small areas of swelling (edema). So I inform my patients routinely that they may have a sore throat after intubation and often some hoarseness with it.
Fortunately only a small number of injuries occur in which the function of the larynx is impaired for longer than a few days. In these cases the small cartilages which make up the structure of the voicebox can be dislocated or fractured. The diagnosis and treatment of these injuries is best undertaken by ENT doctors with special expertise. Ten weeks is certainly long enough to have expected healing of minor injuries to have occurred. Steroids can help reduce swelling and inflammation, and antacids are useful for patients whose hoarseness is caused or exacerbated by acid reflux disease.
A careful history, direct examination, and special studies are needed to assess your laryngeal function and anatomy. The prognosis depends on what is found. It is also important to make certain that you don't have some other disorder that a minor injury from intubation has unmasked.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University