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Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report

RATIONALE: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat. PATIENT CONCERNS: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrod...

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Autores principales: Chun, Eun H., Baik, Hee J., Chung, Rack K., Lee, Hun J., Shin, Kwangseob, Woo, Jae H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690745/
https://www.ncbi.nlm.nih.gov/pubmed/29137052
http://dx.doi.org/10.1097/MD.0000000000008514
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author Chun, Eun H.
Baik, Hee J.
Chung, Rack K.
Lee, Hun J.
Shin, Kwangseob
Woo, Jae H.
author_facet Chun, Eun H.
Baik, Hee J.
Chung, Rack K.
Lee, Hun J.
Shin, Kwangseob
Woo, Jae H.
author_sort Chun, Eun H.
collection PubMed
description RATIONALE: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat. PATIENT CONCERNS: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrodt oral tracheal tube of 7.5 mm internal diameter, was used to successfully intubate his trachea. The duration of surgery was 25 minutes. In the recovery room, he complained of sore throat and dyspnea with inspiratory stridor, which were not resolved after intravenous injection of 10 mg of dexamethasone. DIAGNOSES: The otolaryngological examination revealed midline fixation of the bilateral vocal folds, suggestive of bilateral arytenoid dislocation or bilateral vocal cord palsy. The latter was ruled out because there was no evidence of recurrent laryngeal nerve injury. INTERVENTIONS: Under general anesthesia, a closed reduction was performed using laryngoscopic forceps to apply posterolateral pressure on the arytenoid joints on both sides. Only the dislocation of the left cricoarytenoid joint could be easily reduced, whereas reduction of the right joint was not possible. OUTCOMES: On postoperative day 7, examination with a rigid laryngoscope showed a medially fixed right vocal fold, with full compensation by the left vocal fold. Computed tomography of the neck showed no pathologic findings. Six weeks after surgery, the patient had regained his normal voice with no complications. LESSONS: Although arytenoid dislocation is a rare complication, it should be considered even in patients with uncomplicated tracheal intubation. Early diagnosis and the optimal therapeutic approach are critical for restoration of the patient's original vocal cord function.
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spelling pubmed-56907452017-11-28 Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report Chun, Eun H. Baik, Hee J. Chung, Rack K. Lee, Hun J. Shin, Kwangseob Woo, Jae H. Medicine (Baltimore) 3300 RATIONALE: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat. PATIENT CONCERNS: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrodt oral tracheal tube of 7.5 mm internal diameter, was used to successfully intubate his trachea. The duration of surgery was 25 minutes. In the recovery room, he complained of sore throat and dyspnea with inspiratory stridor, which were not resolved after intravenous injection of 10 mg of dexamethasone. DIAGNOSES: The otolaryngological examination revealed midline fixation of the bilateral vocal folds, suggestive of bilateral arytenoid dislocation or bilateral vocal cord palsy. The latter was ruled out because there was no evidence of recurrent laryngeal nerve injury. INTERVENTIONS: Under general anesthesia, a closed reduction was performed using laryngoscopic forceps to apply posterolateral pressure on the arytenoid joints on both sides. Only the dislocation of the left cricoarytenoid joint could be easily reduced, whereas reduction of the right joint was not possible. OUTCOMES: On postoperative day 7, examination with a rigid laryngoscope showed a medially fixed right vocal fold, with full compensation by the left vocal fold. Computed tomography of the neck showed no pathologic findings. Six weeks after surgery, the patient had regained his normal voice with no complications. LESSONS: Although arytenoid dislocation is a rare complication, it should be considered even in patients with uncomplicated tracheal intubation. Early diagnosis and the optimal therapeutic approach are critical for restoration of the patient's original vocal cord function. Wolters Kluwer Health 2017-11-10 /pmc/articles/PMC5690745/ /pubmed/29137052 http://dx.doi.org/10.1097/MD.0000000000008514 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and noncommercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3300
Chun, Eun H.
Baik, Hee J.
Chung, Rack K.
Lee, Hun J.
Shin, Kwangseob
Woo, Jae H.
Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report
title Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report
title_full Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report
title_fullStr Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report
title_full_unstemmed Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report
title_short Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report
title_sort arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: a case report
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690745/
https://www.ncbi.nlm.nih.gov/pubmed/29137052
http://dx.doi.org/10.1097/MD.0000000000008514
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