気管内挿管が原因と思われた披裂軟骨脱臼例

抄録

We report a case of arytenoid dislocation, which may have been caused by endotracheal intubation.
A 44-year-old man underwent surgery for middle ear cholesteatoma under general anesthesia with endotracheal intubation. The intubation was performed with no difficulty, but at the end of the operation the patient moved strongly before extubation. Postoperatively, he presented hoarseness. Fiberscopic study revealed immobility of the right vocal cord but normal mobility of right arytenoid cartilage, suggesting that the right crico-arytenoid joint may have been dislocated. After two weeks, there was no improvement, and we performed closed reduction. Immediately after fixation with laryngomicrosurgery, there was neither improvement of voice nor mobility of right vocal cord. After he started voice therapy, his voice began to improve, three weeks after the last surgery. Four weeks later, fiberscopic examination showed almost normal mobility of the right vocal cord.
From the literature review, we concluded that closed reductions should be performed as soon as possible after such an incident.