Arytenoid bilateral subluxation following laryngeal mask airway – first case report
DOI:
https://doi.org/10.34631/sporl.1000Keywords:
Laryngeal Mask, Arytenoid Cartilage Trauma, Intubation Complications, Anesthesia Complications, Case ReportAbstract
Background: Laryngeal mask is a very practical every-day device for airway management, with rare complications reported. We did not find reports of bilateral cases, making the present case a singular one.
Methods: A 28-year-old male, with no airway problems expected, submitted to orthopedic surgery with combined brachial plexus block with balanced general anesthesia with easy insertion of the laryngeal mask.
Results: Intense hoarseness was noted immediately in the recovery room, without dyspnea or dysphagia. The videolaryngoscopy observation showed adduction of the vocal folds with apparent bilateral posterior luxation of both arytenoid cartilages. Computerized tomography confirmed the diagnosis. The patient was managed conservatively with rehabilitation, with complete resolution of dysphonia after 4 weeks.
Conclusion: Laryngeal mask is a very convenient tool, especially in emergency settings, and relevant complications remain rare. This singular case illustrates the first published case of bilateral arytenoid dislocation after laryngeal mask airway (LMA) managed conservatively.
References
Pollack CV. The laryngeal mask airway: a comprehensive review for the Emergency Physician. J Emerg Med. 2001 Jan;20(1):53-66. doi: 10.1016/s0736-4679(00)00273-0.
Michalek P, Donaldson W, Vobrubova E, Hakl M. Complications associated with the use of supraglottic airway devices in perioperative medicine. Biomed Res Int. 2015;2015:746560. doi: 10.1155/2015/746560.
Hensel M, Güldenpfennig T, Schmidt A, Krumm M. Continuous cuff pressure measurement during laryngeal mask anaesthesia: an obligatory measure to avoid postoperative complications. Anaesthesist. 2016 May;65(5):346-52. doi: 10.1007/s00101-016-0160-9
Shin HW, Yoo HN2, Bae GE, Chang JC, Park M2, You HS. et al. Comparison of oropharyngeal leak pressure and clinical performance of LMA ProSeal™ and i-gel® in adults: Meta-analysis and systematic review. J Int Med Res. 2016 Jun;44(3):405-18. doi: 10.1177/0300060515607386.
Sataloff RT, Bough ID, Spiegel JR. Arytenoid dislocation: diagnosis and treatment. Laryngoscope. 1994 Nov;104(11 Pt 1):1353-61. doi: 10.1288/00005537-199411000-00007.
Rosenberg MK, Rontal E, Rontal M, Lebenbom-Mansour M. Arytenoid cartilage dislocation caused by a laryngeal mask airway treated with chemical splinting. Anesth Analg. 1996 Dec;83(6):1335-6. doi: 10.1097/00000539-199612000-00037.
Cros AM, Pitti R, Conil C, Giraud D, Verhulst J. Severe dysphonia after use of a laryngeal mask airway. Anesthesiology. 1997 Feb;86(2):498-500. doi: 10.1097/00000542-199702000-00027.
Close LG, Merkel M, Watson B, Schaefer SD. Cricoarytenoid subluxation, computed tomography, and electromyography findings. Head Neck Surg. Jul-Aug 1987;9(6):341-8. doi: 10.1002/hed.2890090607.
Maue WM, Dickson DR. Cartilages and ligaments of the adult human larynx. Arch Otolaryngol. 1971 Nov;94(5):432-9. doi: 10.1001/archotol.1971.00770070678008.
Lee DH, Yoon TM, Lee JK, Lim SC. Treatment outcomes of closed reduction of arytenoid dislocation. Acta Otolaryngol. 2013 May;133(5):518-22. doi: 10.3109/00016489.2012.758387.
Lou Z, Lin Z. The appropriate time for closed reduction using local anesthesia in arytenoid dislocation caused by intubation: a clinical research. Acta Otolaryngol. 2017 Mar;137(3):331-336. doi: 10.1080/00016489.2016.1230276.
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