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Table of Contents
LETTERS TO EDITOR
Year : 2019  |  Volume : 35  |  Issue : 3  |  Page : 413-414

Xanthous vocal cords


Department of Anesthesiology, AIIMS, Rishikesh, Uttarakhand, India

Date of Web Publication3-Sep-2019

Correspondence Address:
Dr. Nishith Govil
Department of Anesthesiology, AIIMS, Rishikesh - 249 201, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacp.JOACP_287_18

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How to cite this article:
Adabala V, Govil N. Xanthous vocal cords. J Anaesthesiol Clin Pharmacol 2019;35:413-4

How to cite this URL:
Adabala V, Govil N. Xanthous vocal cords. J Anaesthesiol Clin Pharmacol [serial online] 2019 [cited 2019 Nov 15];35:413-4. Available from: http://www.joacp.org/text.asp?2019/35/3/413/265918



A 55 year old woman with periampullary carcinoma was planned to undergo Whipple's procedure under general anesthesia. On examination, patient had yellowish sclera and total bilirubin of 26 mg/dL with direct bilirubin of 17.7 mg/dL. Due to anticipated difficult airway fiber-optic intubation was planned (mouth opening of 2 cm and modified Mallampati score of 3). Informed patient consent was obtained and she was sedated with titrated doses of IV fentanyl and midazolam. After appropriate preparation and counseling fiber-optic scope was introduced through the nasal cavity. As we crossed the epiglottis we noticed yellow colored vocal cords (Icteric vocal cords, [Figure 1]). We proceeded to intubate the trachea without any problems. Perioperative period was uneventful.
Figure 1: Xanthous vocal cords

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Bilirubin is the principle bile pigment and is a normal product of red cell degradation. Tissue staining like sclera, skin, and other mucous membranes by bilirubin is frequently noted.[1] Even though there are infrequent reports and images,[2] to our knowledge there is no literature supporting the infiltration of vocal cords by bilirubin.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

No external or any funding, Support was provided solely from institutional and/or departmental sources.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Roche SP, Kobos R. Jaundice in the adult patient. Am Fam Physician 2004;69:299-304.  Back to cited text no. 1
    
2.
Cooper RM. Icteric vocal cords recorded during video laryngoscopy. Anesthesiology 2013;119:1469.  Back to cited text no. 2
    


    Figures

  [Figure 1]



 

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