Heterotopic Ossification of the Vocal Cords After Spinal Cord Injury

J Spinal Cord Med, 2007 · DOI: · Published: January 1, 2007

Spinal Cord Injury Pulmonology Musculoskeletal Medicine

Simple Explanation

Heterotopic ossification (HO) is a condition where new bone forms outside the normal skeletal structure. This case report describes HO occurring in the vocal cords of a patient after a spinal cord injury and multiple traumas. The patient experienced upper airway obstruction due to the ossification, which was discovered after issues arose during decannulation following mechanical ventilation. Surgical intervention involving sawing through the ossified bridge between the vocal cords resolved the obstruction, enabling successful decannulation.

Study Duration

6 Months

Participants

A 55-year-old male

Evidence Level

Case report

Key Findings

1
Heterotopic ossification of the vocal cords can occur as a complication of spinal cord injury and multitrauma.
2
The ossification caused upper airway obstruction, requiring surgical intervention to restore vocal cord mobility.
3
Post-operative diphosphonate drug treatment was used for secondary HO prevention, and the patient showed no recurrent laryngeal impairment during the follow-up period.

Research Summary

This case report describes a rare instance of heterotopic ossification (HO) in the vocal cords of a 55-year-old man following a spinal cord injury and multiple traumas sustained from a fall. The patient developed upper airway obstruction due to bilateral vocal cord fixation caused by hyperossification. Surgical removal of the ossified tissue allowed for successful decannulation. The authors suggest that HO of the vocal cords should be considered in the differential diagnosis of upper airway obstruction in patients with SCI and multitrauma, especially after prolonged intubation.

Practical Implications

Increased Awareness

Raise awareness among specialists treating SCI patients about the possibility of heterotopic ossification in the vocal cords.

Differential Diagnosis

Consider HO in the differential diagnosis of upper airway obstruction post-weaning from mechanical ventilation in SCI and multitrauma patients.

Early Detection

Clinicians should be vigilant for signs of laryngeal involvement (discomfort, odynophagia, dyspnea, hoarseness) in cannulated patients with SCI and multitrauma.

Study Limitations

1
Single case report limits generalizability.
2
The exact mechanism of HO in this specific location remains unclear.
3
A 3-phase bone scintigraphy performed after the surgery did not reveal increased activity.

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