A 32-year-old man with Down’s syndrome was referred to the ear, nose and throat (ENT) department in view of failed attempts at extubation, and subsequently, at decannulation of tracheotomy tube. He had previously required ventilatory support and had history of intubation for 1 week. A flexible fibre-optic laryngoscopy showed a smooth mass covering the laryngeal inlet which moved with respiration. Direct laryngoscopy under general anaesthesia revealed a smooth mucosa covered fleshy mass arising from the left aryepiglottic fold and arytenoid, obstructing the laryngeal inlet. The mass was removed using controlled plasma ablation, and histopathological examination of the same was consistent with lymphangioma. Endoscopic examinations during the regular follow-up visits revealed well-healed supraglottic area with adequate glottic chink and the patient could be successfully decannulated.
- nose and throat/otolaryngology
- mechanical ventilation
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Contributors NC has edited the first draft, assessed and worked up the patient and prepared the patient for surgery. BR has finalised the manuscript, assisted the surgery and was in charge of follow-up of the patient. MM has written the first draft, prepared the final manuscript and was in charge of the patient when admitted in the ward. Professor RSV is the consultant in charge for the patient, had operated on the patient, followed up the patient, has seen, edited and takes responsibility for the manuscript.
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.
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