Despite having intact vocal folds function and anatomy, this patient was unable to vocalized due to complete upper upper tracheal obstruction - no air pass up and beyond true vocal folds to generate mucosal waves although the vocal cords meeting each other nicely. Tracheostomy was performed to bypass the obstructive segment earlier to allow respiration. The obstruction was related to motor vehicles accident with severe intracranial injury and prolonged endotracheal intubation. Tracheal resection and reanastomosis was scheduled.
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