Nasogastric tube syndrome: A Meta-summary of case reports

Table 2 Clinical course of patients with nasogastric syndrome

Case number	Presenting symptoms	Type of feed NGT	Days after which symptoms developed	Side of vocal cords involved	Laryngoscopy	Biopsy	Culture	Therapeutic interventions	Tracheostomy	Outcome	Sequalae
1	Voice change, throat pain	NG	3	B/L	Vocal cord edema, post cricoid abcess	None	None	NG removal, steroids, antibiotics	Yes	Alive	Recovered in 7 d and discharged
2	Sore throat, stridor	NG	8	B/L	Vocal cod edema, arytenoid edema, post cricoid ulceration	None	None	NG removal	Yes	Alive	Recovery in 14 d
3	Throat discomfort, aspiration,	NG	30	B/L	Vocal cord edema and paralysis, postcricoid edema	1	None	NG removal, gastrostomy placement	Yes	Alive	Gastrostomy support required even after 12 wk follow up
4	Stridor, troat pain	NG	9	B/L	Vocal cord paralyis and arytenoid edema	None	None	Removal of tube	Yes	Alive	Recovered completely 15 d after tube removal
5	Stridor, throat pain	NG	18	B/L	Vocal cord edema and post cricoid ulcer	NA	Coagulase positive staph aureus	NGT removal	Yes	Alive	One month after trach – VC mobile, but residual arytenoid edema
6	Throat pain, fever	NG	5		Vocal cord edema and post cricoid ulcer	NA	Streptococcus	NGT removal	No	Alive
7	Stridor	NA	16		Vocal cord edema and post cricoid ulcer	NA	None		Yes	Died
8	Stridor, fever	NG	NA	B/L	B/L vocal cord edema	NA	Candida albicans	NGT removal	Yes	Alive	54 d after – both VC recovered sufficient abductor mobility and decannulation done
9	Stridor	NG	2	B/L	Impaired vocal cord abduction bilaterally. With edema. Postcricoid necrotic ulcer was noted, 1.5 cm in width	No	Mixed bacterial growth	NGT removal	Yes	Alive	No recovery till 1 month
10	SOB	NG	2	B/L	Isolated and complete abductor dysfunction of his vocal cords. With edema. Postcricoid ulceration	No	Mixed bacterial growth	NGT removal, steroids	Yes	Alive	Decannulated after 5 wk
11	Cough, sore throat	NG	9	Left VC paralysis	Left arytenoid fold swollen	No	None	NGT removal	No	Alive	None
12	Incidental	NG	140	Lt	Left- inhibited abductor movement	Yes	None	NG removal	Yes	Alive	Persistent VC palsy
13	Stridor, SOB	Long intestinal tube	4	B/L	Mild arytenoid edema	No	None	Removal of tube	Yes	Alive	Decannulated after 3 wk
14	Stridor	NG	730	B/L	B/L VC edema	No	None	NA	No	Died
15	Stridor	NG	75	B/L	B/L VC edema	No	None	Frequent NG changes	No	Died
16	Stridor, tachypnea, SOB	NG	30	B/L	Right VC paralysis, impaired left VC mobility, B/L edema	No	None	NGT removal, steroids	No	Alive	None
17	Stridor, SOB	NG	35	B/L	Bilateral arytenoid edema	No	None	NGT removal	Yes	Yes	Decannualted after 20 d
18	Stridor, desaturation, AMS	NG	15	B/L	Impaired abduction of the Vocal cords	No	None	NGT removal, steroids	No	Alive	None
19	Stridor, throat pain, desaturation	Long intestinal tube	6	B/L	B/L arytenoid edema	No	None	NGT removal	Yes	Alive	Decannulated after 4 wk
20	Stridor, throat pain, Respiratory distress	NG	14	B/L	Bilateral vocal cord palsy with severely compromised airway.	No	None	NGT removal, steroids	Yes	Alive	Improved after 4 wk
21	Stridor	NG	14	B/L	B/L VC palsy	No	None	NGT removal	No	Alive	None
22	Stridor, slurring of speech, sore throat, difficulty in swallowing, desaturation	NG	7	B/L	B/L vocal cord edema	No	None	NGT removal, steroids	Yes	Alive	A month to complete recovery
23	Wheezing, hoarseness	Nasointestinal ileus tube	3	B/L	Left arytenoid edema and erythema	No	None	Tube removal, steroids	No	Alive	None
24	Incidental	NG	15	B/L	Severe edema	No	None	Inhaled steroids	Yes	Alive	Decannulated after 5 wk
25	Stridor	NG	105	B/L	BL laryngeal edema	No	None	NGT removal	Yes	Alive	None
26	Desaturation	NG	180	Rt	Rt VC palsy	No	None	Neb steroids	NA	Alive	None
27	Stridor	NG	760	Rt	Rt VC palsy	No	None	Neb steroids	NA	Alive	None

¹Proliferative interarytenoid granulation tissue and no abscess.

NG: Nasogastric; B/L: Bilateral; NA: Not available; SOB: Shortness of breath; VC: Vocal cords; NGT: Nasogastric tube.