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Figura 3 bilateral posteriorly, laterally and inferiorly
Cervical CT (axial cut) - bilateral posteriorly luxated arytenoid cartilages, and rotated
luxated arytenoid cartilages
medially in resting (abduction) position
(shown in Fig. 3).
This arytenoid dislocation was presumably
caused by inadvertent malposition of the
LMA, possibly with the tip folded in the
hypopharynx, as other possible causes, as cuff
overpressure, were eliminated.
After diagnosis, he was referred to speech
therapy. The patient recovered rapidly
and was asymptomatic after a month of
treatment. Videolaryngoscopy at 3 months
was normal and he was discharged from ENT
Figura 4
Videolaryngoscopy and stroboscopy after total recuperation. QR code for the video
consultation (figure 4 – QR code for video: published) and its mechanisms are well
5
videolaryngoscopy and stroboscopy after total understood in this setting. However, since
recuperation). using LMA is recent, and arytenoid dislocation
is rare, we still do not fully understand this
Discussion complication related to this method. Even
Arytenoid dislocation is rare and poorly its incidence with LMA is still unknown, and
documented . It’s caused by external neck probably underreported, as for endotracheal
5
trauma or as an iatrogenic injury during/after intubation . We found two published cases of
5
intubation/extubation. unilateral arytenoid luxation after LMA . To
6,7
It can be classified as anterior or posterior . our knowledge, no bilateral arytenoid luxation
5
Regarding the topic of iatrogenic injury, has been described.
the former usually caused by injury during There are several theories to explain the
extubation and the latter from injury due to postintubation injury mechanism. Rosenberg
6
the tip of the laryngoscope during intubation. presumes to be related to direct contact with
Most published literature is related to arytenoids during insertion with inflated
endotracheal intubation (only 57 cases cuff, overpressing the arytenoids, leading
Volume 60 . Nº3 . Setembro 2022 269
