Arytenoid subluxation

2003 ◽  
Vol 172 (4) ◽  
pp. 206-206 ◽  
Author(s):  
JP Dillon ◽  
R Gallagher ◽  
D Smyth
Keyword(s):  
Arytenoid Subluxation

Postintubation Arytenoid Subluxation

1996 ◽  
Vol 105 (5) ◽  
pp. 384-390 ◽  
Author(s):  
Yoav P. Talmi ◽  
Michael Wolf ◽  
Sima Nusem-Horowitz ◽  
Jacob Bar-Ziv ◽  
Jona Kronenberg
Keyword(s):  
Vocal Cord Paralysis ◽  
Clinical Course ◽  
Treatment Options ◽  
Upper Airway ◽  
Pertinent Literature ◽  
Diagnostic Measures ◽  
Joint Surfaces ◽  
External Trauma ◽  
Arytenoid Subluxation ◽  
Unilateral Vocal Cord Paralysis

Arytenoid subluxation (AS), ie, malpositioning of the arytenoid cartilage with abnormal but existent contact between the joint surfaces, is an uncommon entity, and fewer than 70 cases have been reported, 26 of which were in a recently published series. Usually, AS is the result of upper airway instrumentation, and only a few cases were reported to occur with external trauma to the neck. Some predisposing factors and possible mechanisms have been suggested, but the reason for its occurrence remains obscure. Hoarseness and, to a lesser degree, dysphagia, odynophagia, cough, and sore throat may be indicative of AS. Diagnosis is established by the clinical course, laryngoscopy, and computed tomography. Electromyography and strobovideolaryngoscopy are additional diagnostic measures described. We report 7 cases of postintubation AS of long standing. Three of these patients had prior unilateral vocal cord paralysis, formerly undescribed as a possible contributing factor for AS. The pertinent literature is reviewed and treatment options are discussed.

Utility of Helical Computed Tomography in the Study of Arytenoid Dislocation and Arytenoid Subluxation

1997 ◽  
Vol 106 (12) ◽  
pp. 1020-1023 ◽  
Author(s):  
George D. Lyons ◽  
Daniel W. Nuss ◽  
Albert E. Alexander ◽  
Mary A. Fazekas-May ◽  
Lisa David ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Direct Laryngoscopy ◽  
Helical Ct ◽  
Helical Computed Tomography ◽  
Radiographic Examination ◽  
Major Difficulty ◽  
Multiplanar Reconstructions ◽  
Arytenoid Dislocation ◽  
Arytenoid Subluxation

Conventional computed tomography (CT) has been considered a mainstay in the evaluation of the larynx. A major difficulty with utilizing this modality, especially in the study of the arytenoid, is the time necessary to perform a thin-slice examination through a structure that has a propensity to move with respiration and swallowing. Helical CT not only significantly reduces the time necessary to study the larynx, but enables one to perform multiple high-resolution multiplanar reconstructions. Eleven patients with arytenoid abnormalities documented by strobovideolaryngoscopy or direct laryngoscopy were imaged with helical CT. A comprehensive radiographic examination illustrating the cricoarytenoid relationship in all of the subjects was completed in less than 20 seconds by using axial reconstructions in 2-mm-thick slices at 1-mm intervals, with subsequently derived sagittal and coronal reconstructions. Helical CT may be a useful adjunct in the diagnosis of arytenoid subluxation or dislocation.

scholarly journals Arytenoid Subluxation Reduction Using 28-Jackson Dilator

2020 ◽  
pp. 014556132094690
Author(s):  
Annette Kim ◽  
Ghiath Alnouri ◽  
Robert T. Sataloff
Keyword(s):  
Operating Room ◽  
Vocal Fold ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Arytenoid Cartilage ◽  
Vocal Process ◽  
Vehicle Accident ◽  
Patient Reported ◽  
Cricoarytenoid Joint ◽  
Arytenoid Subluxation

Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage subluxation returned to good position using a 28-Jackson dilator. A 66-year-old man was diagnosed previously with right vocal fold paresis and left vocal fold paralysis following a motor vehicle accident that required a 14-day intubation and tracheotomy maintained for 3 weeks. Evaluation by strobovideolaryngoscopy 3 months following the accident showed severe left vocal fold hypomotility and arytenoid height disparity; laryngeal electromyography showed only mild-to-moderate decreased recruitment in laryngeal muscles. No abnormalities were appreciated on neck computed tomography. Upon palpation of both arytenoid cartilages in the operating room, the left joint was found to be subluxed anteriorly and immobile. A 28-Jackson dilator was used to mobilize and reduce the left arytenoid cartilage, and steroid was injected into the cricothyroid joint. Increased mobility was obtained in the operating room and the patient reported significant improvement in his voice. Six months later, we saw improvement in arytenoid height disparity and left vocal fold movement, better glottic closure, and voice handicap index was improved. A 28-Jackson dilator can be used to manipulate the cricoarytenoid joint without trauma to the vocal process.

Anteromedial Arytenoid Subluxation Due to Severe Cough

2018 ◽  
Vol 25 (1) ◽  
pp. 57-59
Author(s):  
Roy Cho ◽  
Feliz Zamora ◽  
H. Erhan Dincer
Keyword(s):  
Arytenoid Subluxation

New Insights into the Pathomechanism of Postintubation Arytenoid Subluxation 

1999 ◽  
Vol 91 (3) ◽  
pp. 659-659 ◽  
Author(s):  
Friedrich P. Paulsen ◽  
Heinrich H. Rudert ◽  
Bernhard N. Tillmann
Keyword(s):  
Joint Surface ◽  
Arytenoid Cartilage ◽  
Abnormal Position ◽  
Joint Surfaces ◽  
Cricoarytenoid Joint ◽  
Left And Right ◽  
Per Se ◽  
Synovial Folds ◽  
Arytenoid Subluxation ◽  
Morphologic Changes

Background Impaired movement of the cricoarytenoid joint with hoarseness and immobility of the vocal ligament can occur as a consequence of endotracheal intubation. The biomechanics and pathomechanism of cricoarytenoid subluxation have not been demonstrated to date. Methods The present study attempts to simulate the trauma that has been associated with arytenoid cartilage subluxation in intubation trials on 37 unfixed larynges in cadavers from persons aged 25 to 89 years. Larynges were intubated or extubated according to former conceptions of arytenoid subluxation, which assume that the arytenoid tip enters the lumen of the tracheal tube, or that a deflection of the arytenoid occurs during withdrawal of the endotracheal tube with the cuff of the tube only partially deflated. Also, manual attempts were carried out to subluxate the arytenoid cartilage. Subsequently after dissecting the left and right cricoarytenoid joint from each larynx, the morphologic changes induced experimentally were analyzed using gross microscopic and histologic methods. Results Within the scope of the experiment, it proved impossible to produce any subluxation of a cricoarytenoid joint. Histologic analysis revealed injuries of synovial folds, joint-surface impressions of the articular cartilage, and fractures in the area of the subchondral bone in some joints. Conclusions Based on the morphologic results, it was concluded that intubation trauma of the cricoarytenoid joint does not cause subluxation per se, but rather that formation of a hemarthros or fractures of the joint bodies lead to fixation of the joint surfaces in an abnormal position. Subsequent ankylosis may occur.

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