|LETTERS TO EDITOR
|Year : 2019 | Volume
| Issue : 3 | Page : 413-414
Xanthous vocal cords
Vijay Adabala, Nishith Govil
Department of Anesthesiology, AIIMS, Rishikesh, Uttarakhand, India
|Date of Web Publication||3-Sep-2019|
Dr. Nishith Govil
Department of Anesthesiology, AIIMS, Rishikesh - 249 201, Uttarakhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Adabala V, Govil N. Xanthous vocal cords. J Anaesthesiol Clin Pharmacol 2019;35:413-4
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.
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. Even though there are infrequent reports and images, 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 The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.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|| |
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