後方型披裂軟骨脱臼症に対する徒手整復術

DOI 被引用文献6件 参考文献11件

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  • Manual Closed Reduction for Posterior Arytenoid Cartilage Subluxation

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Subluxation of the arytenoid cartilage is an usual laryngeal injury that can occur following blunt trauma or medical instrumentation to the laryngeal cavity, for example endotracheal intubation. It is desirable for the reduction technique of the arytenoid cartilage subluxation to be performed easily without physical damage to the patient.<BR>First, we morphologically observed and studied a model of the posterior arytenoid cartilage subluxation that had been extracted and prepared from human cadaver. This model demonstrated that the arytenoid cartilage had been displaced behind the posterior edge of the cricoid cartilage with the posterior cricoarytenoid muscle of the affected side. We could reduce the dislocated arytenoid cartilage manually with ease.<BR>From these results, we have developed a new manual reduction technique for posterior arytenoid cartilage subluxation. The reduction procedure is follows.<BR>(1) Turn over the patient's larynx manually for the affected faces from the surface.<BR>(2) The dislocated arytenoid cartilage can be palpated at the inside of the thyroid cartilage lamina of the affected side (with tenderness).<BR>(3) Pushing the dislocated arytenoid cartilage antero-medially, the affected arytenoid cartilage can be reduced manually by applying pressure until a clicking sound or response is achieved.<BR>We performed the above procedure for 7 patients and found that their posterior arytenoid cartilage subluxation could be reduced with ease resulting in improvement of their symptoms (hoarseness, aspiration, odynophagia).

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