-Case Reports-

Use of a Rigid Curved Laryngoscope for Observation and Debridement of Degenerated Cricoid Cartilage in Nasogastric Tube Syndrome: A Case Report

Kotoko Arai^1,2, Koji Sakamoto¹, Masashi Nakaishi¹, Atsuko Sakanushi¹, Ayaho Yoshino¹ and Kimihiro Okubo¹

¹Department of Otolaryngology, Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan
²Department of Otolaryngology, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan

Nasogastric tube syndrome (NGTS) is a complication of NGT placement that can cause sore throat, bilateral vocal cord paralysis, and airway constriction. Although rare, this condition should be known by all physicians because it is sometimes fatal. We report a case of NGTS that was successfully diagnosed and debrided with a rigid curved laryngoscope. A 79-year-old man was referred to our department for evaluation of persistent pharyngeal pain and dysphagia after thoracic aortic aneurysm surgery. He had restricted bilateral vocal fold abduction, and the NGT had been placed for nearly 120 days. After induction of general anesthesia, the patient underwent laryngeal examination using a rigid curved laryngoscope, which revealed ossified cricoid cartilage in the postcricoid area, leading to confirmation of NGTS. The NGT was removed, and the protruding bony lesion was debrided. Subsequently, the patient underwent gastrostomy to improve his nutritional status. One month later, the postcricoid lesion improved, and the patient was able to tolerate an oral diet. The pathophysiology of NGTS is thought to involve ulceration of the postcricoid mucosa and injury of the posterior cricoarytenoid muscle by contact with the NGT. Although the treatment has not been established, early removal of the NGT is important. In the present case, the rigid curved laryngoscope was useful for resection of the bony lesion, which contributed to early epithelialization and symptom improvement.

J Nippon Med Sch 2025; 92: 374-378

Keywords
nasogastric tube syndrome, rigid curved laryngoscope, cricoid cartilage, vocal cord paralysis

Correspondence to
Koji Sakamoto, Department of Otolaryngology, Head and Neck Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
k-sakamoto@nms.ac.jp

Received, December 31, 2023
Accepted, March 28, 2024