Subluxation of the Cricoarytenoid Joint After External Laryngeal Trauma: A Rare Case and Review of the Literature

Abstract

Cricoarytenoid joint subluxation is rare condition. There are <200 cases reported in the English literature. The most frequent cause of this condition is a traumatic tracheal intubation which account for approximately 80 % of all cases. The most common symptoms are dysphonia and pain of the anterior region of the neck which appear after upper airway manipulation or cervical trauma. In this report we present a well-documented case of a 31 year old male that was referred to the outpatient clinic because of acute dysphonia and pain that appeared immediately after receiving a blow of a soccer ball. Diagnosis was suspected after patient reported the acute onset of symptoms after the traumatic event along with findings in flexible fiberoptic laryngoscopy and videostroboscopy. A CT scan of the larynx was done where the injury of the left cricoarytenoid joint was seen. The patient was informed of the condition and was given the option of surgical reduction or speech therapy. Speech therapy was done for 3 month and the patient was satisfied with the result, although the anatomical abnormality persisted. We reviewed the literature and we discuss the diagnosis process and possible treatment options.

Keywords: Arytenoid dislocation; Arytenoid subluxation; Cricoarytenoid joint; Laryngeal trauma.

Fig. 1

Sagittal CT scan slides. a Arrows show the right arytenoid on top of the cricoid cartilage in a normal position. b Arrows indicate the anterior displacement of the left arytenoid cartilage, consequence of the cricoarytenoid joint dislocation

Fig. 2

a Axial CT scan slide. Medialization of the left arytenoid cartilage and vocal cord is noticed b 3D reconstruction of the glottis, an enlargement of the left piriform sinus can be seen

Fig. 3

Videostroboscopy images obtained after speech therapy. a During inspiration, b during phonation, the persistence of the abnormal position of left arytenoid cartilage can be observed