Case History:
The patient is a 9-year-old boy. 6 years ago, he swallowed detergent, a
strong alkaline substance by accident. Although he expectorated the
substance immediately, he appeared lip edema and burning of the mouth.
Immediately sent to the hospital, gastroscopy showed esophageal injury.
Antibiotics and glucocorticoid were given intravenously. Because the
patient could not ingest food orally, the nasogastric tube was inserted
to guarantee nutritional support. After 7 days of treatment, the patient
showed no symptoms such as hoarseness, dysphagia, or dyspnea, and was
discharged after the nasogastric tube was removed. Pharyngeal stenosis
was not found on examination at this time. One month after the injury,
the patient developed respiratory symptoms such as dyspnea and cough.
Tracheoscopy revealed significant pharyngeal stenosis, but surgery was
not performed due to the patient’s young age and the symptoms were not
obvious.
Before admission this time, the symptoms worsened progressively of
dyspnea, wheezing, slurred speech without obvious causes, while
hoarseness, dysphagia and other symptoms didn’t occur. At admission,
fibrolaryngoscopy showed a defect of the upper epiglottis, adhesion of
the epiglottic stump to the posterior pharyngeal wall, and a small hole
remaining on the right side. Aryepiglottic folds, false and true vocal
folds were smooth (Fig 1).