Heterotopic ossification of the vocal cords after spinal cord injury

Background/Objective: To report a rare complication of heterotopic ossification of the vocal cords after spinal cord and multiple organ injuries. Study Design: Case report. Setting: Acute rehabilitation in the Department of Neurologic Rehabilitation. Results: A 55-year-old patient sustained spinal cord injury and multitrauma after falling from a height. Approximately 3 months later, after weaning from mechanical ventilation, plugging of the cannula resulted in severe stridor indicating upper airway obstruction. A computed tomography scan showed bilateral vocal cord fixation in a para-median position, with hyperossification of the vocal processes of the arytenoids. Direct laryngoscopy revealed interarytenoid ossification, and sawing through the ossification resulted in remobilization of the vocal cords enabling decannulation. Conclusions: Heterotopic ossification of the vocal cords was found to be an early complication of acute spinal cord injury and multiple trauma. This rare complication should be considered in the differential diagnosis of patients showing signs of upper airway obstruction.