A Case of Bilateral Vocal Fold Impairment due to Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disease which primarily involves the synovial membrane in articular capusules, and leads to the destruction of articular cartilage and bone. Laryngeal involvement of RA is not uncommon and sometimes causes arthritis of the cricoarytenoid joint. The occurrence of upper airway obstruction due to immobilization of bilateral vocal folds in RA patients is rare.
　In this article, we reported on a 71-year-old male with RA who also exhibited hoarseness and dyspnea. The diagnosis was made by laryngeal fiberscopy, laryngeal electromyography and Computed Tomography (CT). The bilateral vocal folds were fixed at the median position while a normal electromyogram was recorded, and the cricoarytenoid joint was partially destructed on CT. The patient was treated with an intravenous injection of corticosteroid and surgery (Ejnell's method) after a tracheostomy.