Two cases of arytenoid cartilage dislocation

Abstract

Arytenoid cartilage dislocation has traditionally been relatively rare; however, recently cases caused by endotracheal intubation appear to be increasing. Arytenoid cartilage dislocation can occur anteriorly or posteriorly during the process of intubation. Here, we dealt with two cases of arytenoid dislocation occurring anteriorly and posteriorly after general anesthesia Case 1: A 47-year-old woman underwent an operation for breast cancer under general anesthesia. She suffered hoarseness immediately following intubation and it continued for two months. Videolaryngoscopic examination revealed fixation of the right vocal fold and electromyography revealed electrical activity in the right thyroarytenoid muscle during phonation. We diagnosed right anterior arytenoid cartilage dislocation and undertook manual reduction by laryngomicrosurgery. Postoperatively the patient's hoarseness began to improve gradually and ultimately resulted in improvement of the right anterior arytenoid cartilage dislocation after a period of six months. Case 2: A 35-year-old male underwent an operation for hepatic hematoma under general anesthesia. Hoarseness was noted immediately after intubation and it continued for one week. Videolaryngoscopic examination revealed posterior fixation of the right vocal fold. We diagnosed right posterior arytenoid cartilage dislocation and planned manual reduction by laryngomicrosurgery. However, his child's hand accidentally hit his neck and his hoarseness disappeared; improvement of the right posterior arytenoid cartilage dislocation was also noted.