2 Cases of Arytenoid Cartilage Dislocation

DOI 7 References
  • Fukumori Takayuki
    Department of otolaryngology-head and neck surgery, National Defense Medical College
  • Tomifuji Masayuki
    Department of otolaryngology-head and neck surgery, National Defense Medical College
  • Araki Koji
    Department of otolaryngology-head and neck surgery, National Defense Medical College
  • Shiotani Akihiro
    Department of otolaryngology-head and neck surgery, National Defense Medical College

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  • 披裂軟骨後方脱臼の2例

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Abstract

Arytenoid cartilage dislocation is sometimes caused by endotracheal intubation or external neck trauma. Arytenoid cartilage dislocation is divided into anterior and posterior types according to the direction of dislocation. In this study, we reported on two patients with arytenoid dislocation treated by several methods of repositioning and surgery. <BR>Case1: A 69-year-old female complained of hoarseness after aortic valve replacement. Endoscopic examination revealed the deviation of the left arytenoid toward the posterolateral position and hypokinesia of the left vocal cord during phonation. Endoscopic manual reduction and balloon-reduction were performed and arytenoid cartilage movement improved one month later. <BR>Case2: A 68-year-old male who had the habit of self-induced vomiting after consuming alcohol. One day, he complained of a sore throat after self-vomiting, and hoarseness emerged three days later. The local otolaryngologist found immobility of the right vocal fold and referred him to our hospital. His maximum phonation time (MPT) was 1.7 seconds at first visit. Endoscopic examination suggested dislocation of the left posterior arytenoid cartilage. Computed tomography (CT) imaging was helpful in the evaluation of patients. Electromyography revealed reduced electrical activity in the thyroarytenoid muscle during phonation. We diagnosed right posterior arytenoid dislocation. Neither endoscopic balloon-reduction nor manual-reduction could improve arytenoid movement. We applied the surgical system of Transoral videolaryngoscopic surgery (TOVS) for the arytenoid reduction which was effective for evaluation of arytenoid movement during the surgery. His arytenoid seemed to be re-dislocated. A right arytenoid adduction and Type I thyroplasty was performed. The hoarseness improved immediately. MPT improved remarkably from 1.7 to 32 seconds 17 days after surgery. (254 words)

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