Arytenoid Subluxation

Excerpt

Arytenoid subluxation is a rare but clinically significant complication of airway manipulation, capable of causing persistent voice changes and functional impairment. The condition involves partial displacement of the arytenoid cartilage within the cricoarytenoid joint. This entity is distinct from complete arytenoid dislocation, which entails total separation of the cartilaginous surfaces. Although the terms "subluxation" and "dislocation" are often used interchangeably in clinical practice, precise differentiation is essential for diagnostic accuracy and treatment planning.

Contemporary evidence suggests that arytenoid subluxation may be more common than previously recognized. Recent data indicate a pooled incidence of 0.093% (confidence interval: 0.045-0.14%) among patients undergoing endotracheal intubation. This update reflects both improved diagnostic techniques and heightened clinical awareness. The discrepancy between historical and contemporary incidence rates likely results from underdiagnosis due to confusion with vocal fold immobility from other causes, such as recurrent laryngeal nerve (RLN) paralysis.

Recent advances in diagnostic imaging, particularly dynamic computed tomography (CT) and ultrasonography, have enhanced the ability to diagnose and characterize arytenoid subluxation accurately. Treatment strategies have evolved, with evidence supporting early intervention and specific techniques that optimize patient outcomes.