Cricoid cartilage necrosis after arytenoidectomy in a previously irradiated larynx

Several open and endoscopic surgical techniques are available to provide an adequate airway for patients with bilateral vocal cord paralysis. Transora l laser arytenoidectomy has repeatedly been reported to be a reliable and e ffective minimally invasive procedure for airway restoration. To our knowle dge, there have been no previous reports of serious complications, other th an poor vocal results, aspiration, and failed decannulation in individual p atients, that have resulted from this intervention. We report a case in whi ch arytenoidectomy Zed to severe complications and death. Prior irradiation is suspected to be a causative factor. To prevent such an outcome, we beli eve that operative settings should be chosen that avoid deep thermal injury of the laryngeal framework.