A Case of Vocal Fold Adhesion Possibly Secondary to Endotracheal Intubation after Pesticide Ingestion

We herein report a case of vocal fold adhesion possibly secondary to endotracheal intubation after pesticide ingestion in a 72-year-old woman with a history of schizophrenia who had ingested a commercial pesticide in a suicide attempt 24 years earlier. The patient was intubated and subsequently self-extubated. In the present era, she was referred to our department because of difficulty achieving intubation during a recent surgical procedure. Laryngeal endoscopy revealed bridge-shaped adhesions in the membranous portions of both vocal folds. Given her psychiatric condition and the risks of general anesthesia, we performed transoral surgery for adhesions under local anesthesia using a transoral knife. The procedure was successful, and seven weeks postoperatively, oral intubation for orthopedic surgery was feasible. No recurrence of adhesions was noted at one year after surgery. This case suggests that transoral surgery under local anesthesia should be considered.