Value of three-dimensional CT in the diagnosis of cricoarytenoid dislocation / 中华放射学杂志

Objective:To investigate the value of three-dimensional (3D) CT in diagnosing cricoarytenoid dislocation.Methods:From January 2021 to December 2021, 31 patients with unilateral cricoarytenoid dislocation who had been treated by reduction forceps at the Affiliated BenQ Hospital of Nanjing Medical University were collected retrospectively, and their voice recovered or improved significantly after therapy. The preoperative CT images were reconstructed by volume rendering (VR). The dislocated side (left and right), type of dislocation (total dislocation and subluxation), and dislocation direction (anterior, posterior, internal and external dislocation) of cricoarytenoid dislocation were observed. According to arytenoid articular surface of cricoid cartilage exposed completely or not (caused by arytenoid displacement), they were divided into complete dislocation and subluxation. According to the direction of arytenoid displacement and the part of arytenoid articular surface of cricoid cartilage exposed, they were divided into anterior, posterior, internal and external dislocation. According to the shape of the vocal cords on laryngoscope, anterior and posterior dislocation of each case was judged, and then compared with that of CT.Results:On VR images, there were 28 cases of cricoarytenoid subluxation (90.3%, 28/31) and 3 cases of complete dislocation (9.7%, 3/31). Left cricoarytenoid dislocation was 26 cases (83.9%, 26/31) and right cricoarytenoid dislocation was 5 cases (16.1%, 5/31). Posterior dislocation was 28 cases (90.3%, 28/31) and anterior dislocation was 3 cases (9.7%, 3/31). There were 23 cases of internal dislocation (74.2%, 23/31), 2 cases of external dislocation (6.4%, 2/31), and 6 cases without obvious internal and external dislocation (19.4%, 6/31). Three cases of complete dislocation were left posterior internal dislocation.There were 24 cases of left posterior dislocation (77.4%, 24/31), 4 cases of right posterior dislocation (12.9%, 4/31), 2 cases of left anterior dislocation (6.4%, 2/31) and 1 case of right anterior dislocation (3.2%, 1/31). On laryngoscope, there were 19 cases of posterior dislocation (61.3%, 19/31), 9 cases of anterior dislocation (29.0%, 9/31), 3 cases were difficult to assess (9.7%, 3/31) because of aryepiglottic fold covering. Sixteen cases (55.2%, 16/28) were consistent with 3D CT, and 12 cases (42.8%, 12/28) were inconsistent.Conclusion:The 3D CT is a reliable method to evaluate cricoarytenoid dislocation, which can show dislocated side, type and direction of cricoarytenoid dislocation clearly.

Bilateral cricoarytenoid joint ankylosis with a perplexing etiology

@#Immobility, fixation, or paralysis of the vocal folds is an ominous sign when encountered in the clinics. This may be due to a variety of diseases, lesions, injuries, or vascular compromise which may affect the integrity and physiologic mechanism of the vocal folds. The common etiologies include infectious processes such as laryngeal or pulmonary tuberculosis (PTB), malignancy or neoplasms, central problems such as cerebrovascular accidents (CVA), stroke and others.1,2,3 The problem should be addressed immediately because this potentially life threatening and imminent narrowing of the glottic opening may lead to respiratory distress. Vocal fold paralysis due to compression of the recurrent laryngeal nerve from PTB and laryngeal cancer are perennially seen in clinical practice, but immobility of the vocal folds due to cricoarytenoid joint fixation or ankylosis is seldom seen and appreciated. Hence, we present a case of bilateral cricoarytenoid joint ankylosis and discuss its etiology, pathophysiology, differential diagnoses, ancillary procedures, and management.

Bilateral Cricoarytenoid Arthritis: A Cause of Recurrent Upper Airway Obstruction in Rheumatoid Arthritis

We report a case of bilateral cricoarytenoid joint arthritis with history of rheumatoid arthritis, presented with stridor to the outpatient department. Endolaryngoscopy revealed adducted vocal cords and a nodule over left arytenoid which later confirmed to be rheumatoid nodule on histopathologic examination. Initially, although patient responded well to medical treatment, recurrence was noticed after 6 months follow-up.

Synovial tissue morphology of the cricoarytenoid joint in the elderly: a histological comparison with the cricothyroid joint / 대한해부학회지

We compared the age-related morphology of the cricothyroid (CT) joint with that of the cricoarytenoid (CA) joint using 18 specimens from elderly cadavers in terms of their elastic fiber contents as well as the cells composing the joint capsule and synovial tissues. In contrast to an almost flat-flat interface in the CT joint, the CA joint was similar to a saddle joint. The CA joint capsule was thin and contained few elastic fibers, and in contrast to the CT joint, external fibrous tissues were not exposed to the joint cavity, there being no injury to the CA joint capsule. The lateral and posterior aspects of the CA joint were covered by the lateral and posterior CA muscles, respectively, and the fascia of the latter muscle was sometimes thick with abundant elastic fibers. However, due to possible muscle degeneration, loose connective tissue was often interposed between the fascia and the capsule. The medial and anterior aspects of the CA joint faced loose tissue that was continuous with the laryngeal submucosal tissue. Therefore, in contrast to the CT joint, a definite supporting ligament was usually absent in the CA joint. Synovial folds were always seen in the CA joint, comprising a short triangular mass on the posterior side and long laminar folds on the anterior side. The synovial folds usually contained multiple capillaries and a few CD68-positive macrophages. High congruity of the CA joint surfaces as well as strong muscle support to the arytenoid cartilage appeared to provide the specific synovial morphology.

A Case of Bilateral Vocal Fold Paralysis Induced by Concurrent Rheumatoid Arthritis Involvement of Laryngeal Nerve and Cricoarytenoid Joint

Rheumatoid arthritis (RA) is a connective tissue disease involving the larynx in 30% of the patients. Foreign body sensation, hoarseness, and cough are common symptoms in laryngeal involvement. An urgent tracheostomy is required when acute airway obstruction occurs in case of bilateral vocal fold paralysis. The most common cause of bilateral vocal fold paralysis in RA patients is a cricoarytenoid joint arthritis. Laryngeal nerve degeneration is rare cause of bilateral vocal fold paralysis in RA patients. In this case report, an emergent tracheostomy was performed on a 64-years-old male patient with acute dyspnea, and concurrent involvement of RA on laryngeal nerve and cricoarytenoid joint was revealed by laryngeal electromyography and histopathology. The vocal fold mobility was restored after 3-months medical treatment.

Morphological Alteration and the Protein Expression of Caspase -3 in Denervated Posterior Cricoarytenoid Muscles / 听力学及言语疾病杂志

Objective To investigate the morphological alteration and the protein expression of caspase -3 in long -term denervated posterior cricoarytenoid muscles (PCAMs)in order to find the appropriate time point of rein‐neration in long -term denervated PCAMs .Methods A total of 45 patients with vocal paralysis were recruited and devided into 3 groups ,the 3~6 months denervation group ,the 6~12 months denervation group ,the 1~2 year denervation group .12 adults served as control group .The morphological alteration was evaluated using HE staining and the change in expression of caspase -3 ,an apoptosis related factor ,were observed using immunehistochemistry stain and western blot .Results With elongation of denervation time ,there were increased denaturation in the mus‐cle fibers .The nucleus moved inside and some of them concentrated .Caspase-3 showed weak staining in innerva‐ted ,however ,by 3-6 months of muscle denervation there was a significant accumulation of caspase -3 protein in myofibers ,6~12 months and 1~2 years of denervation ,expression of caspase -3 protein in myofibers was de‐creased significantly .In western blot ,the change in protein expression of caspase -3 was observed an 21-fold (P< 0 .01) increase from 3~6 months denervated muscles to innervated muscles ,11-fold (P< 0 .01) increase from 6~12 months denervated muscles to innervated muscles ,3~fold (P< 0 .01) increase from 1~2 year denervated muscles to innervated muscles .Conclusion The morphological alterations and changes in expression of caspase -3 indicated there was a high amplitude of apoptosis in denervated posterior cricoarytenoid muscles within 1 year .

The Morphology Observation of Posterior Cricoarytenoid Muscle Myofiber in Patients with Idiopathic Vocal Fold Paralysis / 听力学及言语疾病杂志

Objective To investigate the morphology change of posterior cricoarytenoid muscle myofiber in patients with idiopathic vocal fold paralysis and to provide experimental evidence for the clinical treatment of idio‐pathic vocal cord paralysis .Methods Thirty -nine cases of vocal fold paralysis patients were recruited into and di‐vided into 2 groups :idiopathic vocal cord paralysis group(n=16) ,and traumatic vocal cord paralysis group(n=23) . Both groups were further divided into 3 subgroups:0 .5~1 year(5 cases and 7 cases) ,>1~2 years(5 cases and 10 cases) ,>2 years(6 cases and 6 cases) .Part of posterior cricoarytenoid muscle(PCAM ) were acquired from all of vo‐cal cord paralysis patients .Normal human posterior cricoarytenoid muscles were treated as the control group (n=5) . They were all stained with Masson three-color staining ,the fiber crosssectional area of muscle tissue and collagen connective tissue were quantitatively analyzed with the image pro plus analysis system .Differences of two observa‐tion indexes were compared with each other among groups and subgroups .Results The number of myofibers was decreased ,but the numbers of the collagen fibers was increased with the onset time course extension ,the ratio of cross sectional area of myofibers to those of collagen fibers was progressively decreasd with increased time course of denervation and more decrease within 1 year .There was obvious difference between the control group and 0 .5~1 year ,>1~2 years ,>2 years subgroup of idiopathic vocal cord paralysis (P1~2 years subgroup and >2 years subgroup ,the trend of shrinking still existed .Com‐pared two observation indexes of traumatic vocal cord paralysis with the same period subgroup indexes of idiopathic vocal fold paralysis ,there was no significant difference about these two observation indexes (P>0 .05) .In some special cases with 10 years duration in idiopathic vocal cord paralysis group ,the posterior cricoarytenoid muscle at‐rophy fibrosis was not serious .However ,in some case which the course lasted for only 1 .5 years ,the muscle atrophy was very obvious .There were great individual differences among idiopathic vocal cord paralysis patients .Conclusion If there is no recovery after half year treatment ,for PCA muscle function recovery ,the recurrent laryngeal nerve injury repair surgery could be considered to carry out within 1 year .In some cases with long disease duration (>2 years) ,they may still have the muscle morphological basis for nerve repair .

Intraoperative assessment of recurrent laryngeal nerve function by monitoring EMG of lateral cricoaryteoid muscle / 中华普通外科杂志

ObjectiveTo investigate the effectiveness and feasibility of intraoperaive recurrent laryngeal nerve(RLN) monitoring via lateral cricoarytenoid muscle(LCA) compound muscle action potential (CMAP) monitoring by bipolar electrode implanting. MethodsSeventy-four cases were evenly divided into nerve monitoring group and non-monitoring group,NIM-Response 2.0 was applied into monitoring group for intraoperative nerve monitoring.A bipolar electrode was inserted into LCA to record CMAP,stimulating electrode intermittently stimulated exposed or unexposed recurrent laryngeal nerve to monitor the RLN function during cervical operation under the block anaesthesia of cervical plexus. ResultsThere were no statistically significant differences (P ＞ 0.05 ) in postoperative hospitalization days (5.14 ± 1.44 days,5.05 ± 1.31 days),operation time ( 125.54 ±42.23 min,107.30 ± 39.36 min) between monitoring group and the control group.Thirty-two RLNs were mapped their anatomical course with the NIM-Response 2.0 assistance before exposure,and 25 RLNs were anatomically exposed.The stimulating threshold between unexposed RLN (2.23 ± 0.57 mA) and exposed RLN ( 0.44 ± 0.20 mA) were statistically different ( P ＜ 0.01 ),but the evoked EMG amplitude(307.98 ± 253.47 μV,234.36 ± 142.18 μV) were not statistically different (P ＞ 0.05 ).With the NIM-Response 2.0 assistance the course of the unexposed RLNs detected were consistent to the course of the RLNs when exposed completely.ConclusionsIt is a effective and feasible method to monitor the RLN function by recording the CMAP of lateral cricoarytenoid muscle(LCA) via bipolar electrode implanted into LCA under block anaesthesia of the cervical plexus.

Intraoperative recurrent laryngeal nerve monitoring during thyroid surgery under block anaesthesia of the cervical plexus / 中华普通外科杂志

Objective To investigate the monitoring of the recurrent laryngeal nerve (RLN)function during thyroid surgery by recording the compound muscle action potential (CMAP) of lateral cricoarytenoid muscle(LCA) under block anaesthesia of the cervical plexus. Methods Nicolet Endeavor CR(Viasys Healthcare, USA) was applied for the intraoperative monitoring. A pair of needle electrodes were inserted into LCA to record CMAP, and a concentric electrode was used to intermittently stimulate the RLN for monitoring the RLN function during operation under block anaesthesia of the cervical plexus.Results In these 28 cases 31 RLNs were exposed during operation, CMAPs appeared with consistent latency when stimulation was applied at the exposed segment. The stimulating intensity threshold ranged from 0.2 to 1.6 mA. The average value was 0.96 mA. 25 of 31 showed CMAPs with consistent latency when stimulation was provided along the possible pathway of the unexposed segment. The stimulating intensity threshold ranged from 1.3 to 3.5 mA. The average value was 2. 03 mA. 6 of 31 did not evoked CMAP even though the maximal stimulating intensity was 5 mA. When these six nerves were exposured, compound muscle action potential were evoked consistently. All of the 28 patients had normal phonation function after surgery.Conclusions It is a safe, effective and feasible method to monitor the RL N function by recording the CMAP of lateral cricoarytenoid muscle under block anaesthesia of the cervical plexus.

Changes of myogenin expression in long-term denervated human posterior cricoarytenoid muscles / 第二军医大学学报

Objective: To investigate the change in myogenin expression at different time in long-term denervated human posterior cricoarytenoid muscles (PCAMs), so as to provide a theoretical basis for timing of reinnervation. Methods: Thirty-eight specimens of denervated human PCAMs were divided into 4 groups according to the period of denervation: 6-12 months denervation group(n= 12), 1-2 years denervation group (n = 10), 2-3 years denervation group (n = 8), and over 3 years denervation group(n=8). Another 12 specimens of normal PCAMs served as control. The patients in all groups were age- and sex-matched. The expression of myogenin protein and mRNA was studied using immunofluorescence staining and real-time PCR analysis, respectively. Results: Immunofluorescence staining showed that the positive myogenin expression was mainly found in the myonuclei of PCAMs with a denervation period less than 3 years; no positive staining was found in the myonuclei of control group. The expression of myogenin in myonuclei and the ratio of positive cells were up-regulated in the 6-12 month denervation group compared with those in the control group; the expression and the ratio peaked in 1-2 years denervation group and decreased again in the 2-3 years denervation group, but was still significantly higher than those of the control group (all P< 0.01). There was hardly any expression of myogenin 3 years after denervation. Results of RT-PCR showed no myogenin mRNA expression in the control group; the expression in 1-2 years, 2-3 years, and more than 3 years denervation groups were 4 times, 64 times, and half that of the 6-12 months denervation group, respectively (all P<0.05). Conclusion: It is indicated that there is a potential for muscle regeneration within 3 years of denervation.

Myofiber morphology of posterior cricoarytenoid muscles in patients with long-term denervation of recurrent laryngeal nerve / 第二军医大学学报

Objective: To study the morphological changes of posterior cricoarytenoid muscles (PCM) in patients with longterm denervation of recurrent laryngeal nerve (RLN), so as to provide theoretical evidence for repair of recurrent laryngeal nerve at advanced clinical stage. Methods: Thirty-eight patients with damaged RLN were divided into 4 groups according to the duration of their RLN damage: 6-12 months group (n = 12), 1-2 years group (n = 10), 2-3 years group (n = 8), and over 3 years group (n = 8). Twelve subjects with normal PCM served as control. Trichrome Masson staining and imaging analyzing system were used to quantitatively analyze the transverse section areas of myofibers, collagen fiber and connective tissues. SDH and AchE staining and cell counting method were used to analyze changes of two kinds of myofibers and motor end plate numbers at different times after denervation of recurrent laryngeal nerve. Results: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation; the difference was significant between different groups (P<0.01). The ratio of transverse area of myofiber to that of collagen fibers reached the lowest level 0.5-2 years after denervation. The fibrosis of muscle obviously slowed down 2 years after denervation. The transverse section of 48% of myofibers remained 3 years after denervation, Long-term denervation resulted in the changes of muscle fiber types: the ratio of red muscles was increased and the ratio of white muscles was decreased after denervation; the difference was significant between different groups (P < 0.01). The number of motor end plate decreased with the prolongation of denervation and disappeared after 1 year. Conclusion: The morphological alteration in long-term denervation PCM indicates the worst myofibrosis occurs within 2 years of denervation, but 48%of myofibers remain 3 years after denervation. The type alteration of denervated muscles may decrease the apoptosis of skeletal muscle. The structure of myoceptors disappears within 1 year of denervation. Our experiment indicates that there is a morphological basis for regaining total or partial muscle function by nerve repair after long-term denervation.

A Case of Ankylosing Spondylitis with Cricoarytenoid Arthritis / 대한류마티스학회지

The cricoarytenoid joint is a diathrodial synovial joint and it can be affected by various diseases. The etiology includes infectious, rheumatic and degenerative diseases. Cricoarytenoid arthritis that's caused rheumatoid arthritis is the most well known, yet cricoarytenoid arthritis that's caused by ankylosing spondylitis is very rare. Hoarseness, dysphagia, throat discomfort, dyspnea and dyspnea on exertion are the major symptoms. If there was no severe airway obstruction, this condition can be managed by systemic steroid or intraarticular steroid injection. We experienced a case of a 47 years old man with ankylosing spondylitis and he presented with hoarseness, dyspnea on exertion and dysphagia. He was finally diagnosed with cricoarytenoid arthritis and he improved after etanercept administration. So we report here on this case along with a review of relevant literature.

Electromyographic study of suprahyoid muscles and intrinsic laryngeal muscles in dogs / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the synchronous electromyograhic features of suprahyoid muscles [anterior digastric muscle(AD), posterior digastric muscle(PD),stylohyoid muscle(STH),mylohyoid muscle(MH)and geniohyoid muscle(GH)] and intrinsic laryngeal muscles [lateral cricoarytenoid muscle(LCA)and posterior cricoarytenoid muscle(PCA)]. METHODS Synchronous electromyograhic features of 13 dogs were observed under the circumstances of breath, swallowing and phonation. RESULTS ①AD, PD, STH, MH, GH and PCA discharged during inspiratory phase, while LCA discharged during expiratory phase. ②During swallow, suprahyoid muscles and LCA showed intensive synchronous discharge. The myoelectricity of PCA was suppressed while myopotential can be detected during intermission. ③During phonation, AD, PD, LCA and PCA showed an intensive synchronous discharge, while emergence time of PCA was later. GH and STH showed no myoelectricity activities. CONCLUSION①During phonation and swallowing, MH is synchronized with LCA. It can be chosen as the backup muscle for the reestablishment of glottic adduct function. ②During inspiratory phase, GH is synchronized with PCA. It can be chosen as the backup muscles for the reestablishment of vocal cord abduct function.

The mRNA Expression of Different Muscle Fibre Types in Denervated Rat Musculus Cricoarytenoideus Posterior / 听力学及言语疾病杂志

Objective To investigate the expression of the mRNA of muscle fibre types in the denervated post cricoarytenoid(PCA)muscle of rat.Methods Unilateral recurrent laryngeal nerve of eight rats were removed.Eight rats were used as controls.The mRNA expression of heavy chain myosin of PCA muscle fibre subtypes was measured with real-time quantitative RT-PCR in control rats and denervated rats 40 days after denervation.Results Compared to the control group,there were no significantly differences in mRNA expression of each muscle subtype between two groups.The ratio of MyHC type I to IIB was increased significantly(P=0.018).Conclusion The increased ratio of MyHC subtype I to IIB suggests the decreased contraction power of denervated PCA muscle.

Myofiber morphology of posterior cricoarytenoid muscles in patients with long-term denervation of recurrent laryngeal nerve / 第二军医大学学报

Objective:To study the morphological changes of posterior cricoarytenoid muscles(PCM) in patients with long-term denervation of recurrent laryngeal nerve(RLN),so as to provide theoretical evidence for repair of recurrent laryngeal nerve at advanced clinical stage.Methods: Thirty-eight patients with damaged RLN were divided into 4 groups according to the duration of their RLN damage: 6-12 months group(n=12),1-2 years group(n=10),2-3 years group(n=8),and over 3 years group(n=8).Twelve subjects with normal PCM served as control.Trichrome Masson staining and imaging analyzing system were used to quantitatively analyze the transverse section areas of myofibers,collagen fiber and connective tissues.SDH and AchE staining and cell counting method were used to analyze changes of two kinds of myofibers and motor end plate numbers at different times after denervation of recurrent laryngeal nerve.Results: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation;the difference was significant between different groups(P

Changes of myogenin expression in long-term denervated human posterior cricoarytenoid muscles / 第二军医大学学报

Objective:To investigate the change in myogenin expression at different time in long-term denervated human posterior cricoarytenoid muscles(PCAMs),so as to provide a theoretical basis for timing of reinnervation.Methods: Thisty-eight specimens of denervated human PCAMs were divided into 4 groups according to the period of denervation: 6-12 months denervation group(n=12),1-2 years denervation group(n=10),2-3 years denervation group(n=8),and over 3 years denervation group(n=8).Another 12 specimens of normal PCAMs served as control.The patients in all groups were age-and sex-matched.The expression of myogenin protein and mRNA was studied using immunofluorescence staining and real-time PCR analysis,respectively.Results: Immunofluorescence staining showed that the positive myogenin expression was mainly!found in the myonuclei of PCAMs with a denervation period less than 3 years;no positive staining was found in the myonuclei of control group.The expression of myogenin in myonuclei and the ratio of positive cells were up-regulated in the 6-12 month denervation group compared with those in the control group;the expression and the ratio peaked in 1-2 years denervation group and decreased again in the 2-3 years denervation group,but was still significantly higher than those of the control group(all P

Dislocation of Cricoarytenoid Cartilage after Inadvertent Extubation with Cuff Inflation: A Case Report / 대한마취과학회지

Dislocation of cricoarytenoid cartilage (CAC) is one of rare but serious complications of endotracheal intubation. A 46-year-old woman was admitted for removal of hypoglossal neurinoma. To maintain the airway a few more days, the authors changed orotracheal intubation into nasotracheal intubation after operation. But accidently the patient removed the nasotracheal tube with ballooning state by herself twice in the intensive care unit. One day later she was ambulatory and complained of swallowing difficulties, hoarseness, frequent coughing and respiratory difficulty due to repeated aspiration. So, videostrobolaryngoscopy and electromyelography were performed and the authors diagnosed bilateral posterior displacement of CAC due to forceful removal of the nasotracheal tube in ballooned state. Emergency operation for reduction of CAC was performed. Left side was reduced successfully but right side reduction was failed. Tracheostomy was done to maintain respiratory hygine. Fifty-five days after operation the patient was discharged in improved state. In case of dislocation of CAC, early diagnosis and reduction is mandatory.

Recurrent Laryngeal Nerve Paralysis Associated with Cricoarytenoid Subluxation Following General Anesthesia: A case report / 대한마취과학회지

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.

A Case of Cricoarytenoid Joint Dislocation due to Blunt Trauma to the Larynx / 대한이비인후과학회지

Cricoarytenoid joint dislocation is not an uncommon complication resulting from intubation trauma or blunt trauma to the neck, yet it has been poorly documented. Hoarseness is the most prevalent symptom, and poor mobility of the vocal fold is the most common sign. It is best evaluated by stroboscopic examination combined with laryngeal electromyography(EMG). Early diagnosis is important for appropriate surgical management and better prognosis. Closed reduction of dislocated joint is the treatment of choice. A case of cricoarytenoid joint dislocation after blunt trauma to the anterior neck is presented with a brief review of literature.

Cricoarytenoid Subluxation after Tracheal Intubation: A case report / 대한마취과학회지

Arytenoid cartilage displacement (dislocation and subluxation) following endotracheal intubation is a rare event. Recognition of its occurrence and subsequent treatment are important to prevent longterm consequences. A 44-year-old healthy woman was admitted for total thyroidectomy and isthmusectomy. Anesthesia was induced and a number 7 cuffed endotracheal tube with a stylet was inserted under direct vision after two unsuccessful attempts without a stylet. The trachea was extubated without any difficulty in the recovery room after the surgery. About 8 hours later, the patient complained odynophagea, dysphagea, dysphonia and hoarseness. Indirect laryngoscopy and videolaryngotelescopy at the otolaryngology department revealed anterior subluxation of both cricoarytenoid cartilages with poor mobility and edema on the vocal cords. A follow-up indirect laryngoscopic examination performed after 5 days of conservative trearment showed return of the voice quality with slightly reduced mobility on the left vocal cord.