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Case report
Emergency presentation of iatrogenic airway stenosis following intubation in a patient with COVID-19 and its management
  1. Gerard Thong1,
  2. Harry Lorenz1,
  3. Guri S Sandhu1 and
  4. Chadwan AlYaghchi2
  1. 1National Centre for Airway Reconstruction, Imperial College London, London, UK
  2. 2Imperial College London, London, UK
  1. Correspondence to Mr Gerard Thong; gerardthong{at}


A 59-year-old man presented to the emergency department with recent onset biphasic stridor, dyspnoea and increased work of breathing on the background of prolonged intubation for the novel COVID-19 2 months previously. Flexible laryngoscopy revealed bilateral vocal fold immobility with a soft tissue mass in the interarytenoid region. The patient’s symptoms improved with oxygen therapy, nebulised epinephrine (5 mL; 1:10 000) and intravenous dexamethasone (3.3 mg). The following morning, the patient was taken to theatre, underwent suspension microlaryngoscopy and found to have bilateral fixation of the cricoarytenoid joints and a large granuloma in the interarytenoid area. He underwent cold steel resection of the granuloma and balloon dilatation between the arytenoids, with the hope of mobilising the joints. This failed and CO2 laser arytenoidectomy was performed on the left side. The stridor had resolved postoperatively, with normalisation of work of breathing and the patient was discharged home on the first postoperative day.

  • ear
  • nose and throat/otolaryngology
  • adult intensive care
  • otolaryngology / ENT

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  • Contributors GT and HL were involved in drafting the manuscript. GT, CAY and GSS were involved in revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.