# Unexpected Aphonia: A Rare Complication of the Nasopharyngeal Airway (NPA) and Proposed Design Improvements

## TL;DR

A patient experienced unexpected loss of voice after a medical procedure, and the paper suggests a design change to prevent such complications.

## Contribution

First reported case of prolonged aphonia after NPA use and a proposed design improvement to prevent it.

## Key findings

- Aphonia occurred without respiratory distress after NPA use in a tongue cancer patient.
- A design modification is proposed to prevent NPAs from slipping into the nasopharynx or larynx.

## Abstract

Patients with airway foreign bodies typically present with difficulty breathing or stridor. Nasopharyngeal airway (NPA)-related complications are rarely reported. We present a case of a patient with carcinoma of the tongue who underwent nasal intubation for surgery using a flexible bronchoscope. This case is unique because the patient experienced prolonged aphonia without respiratory distress, representing a first-of-its-kind report. We also propose a minor modification to the NPA design to reduce the risk of it slipping into the nasopharynx or larynx.