Delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the intensive care unit:A case report  

作　　者：Weng-Qing Yan Chen Li Zhi Chen 

机构地区：[1]Medical Department of Graduate School,Nanchang University,Nanchang 330006,Jiangxi Province,China [2]Department of Emergency,Jiangxi Provincial People’s Hospital,Nanchang 330006,Jiangxi Province,China [3]Department of Traumatology,Jiangxi Provincial People’s Hospital,Nanchang 330006,Jiangxi Province,China

出　　处：《World Journal of Clinical Cases》2022年第15期5119-5123,共5页世界临床病例杂志

基　　金：Supported by the National Natural Science Foundation of China,No.82160020.

摘　　要：BACKGROUND Arytenoid cartilage dislocation is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma.The most common symptom is persistent hoarseness.Although cases of arytenoid dislocation due to tracheal intubation are reported more frequently in otolaryngology,reports on its occurrence in the intensive care unit(ICU)are lacking.We report a case of delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the ICU.CASE SUMMARY A 20-year-old woman was referred to the ICU following a fall from a height.Her voice was normal;laryngeal computed tomography showed unremarkable findings on admission.However,due to deterioration of the patient’s condition,tracheal intubation,and emergency exploratory laparotomy followed by laparoscopic surgery two d later under general anesthesia were performed.After extubation,the patient was sedated and could not communicate effectively.On the 10th day after extubation,the patient complained of hoarseness and coughing with liquids,which was attributed to laryngeal edema and is common after tracheal intubation.Therefore,specific treatment was not administered.However,the patient’s symptoms did not improve.Five d later,an electronic laryngoscope examination revealed dislocation of the left arytenoid cartilage.The patient underwent arytenoid closed reduction under general anesthesia by an experienced otolaryngologist.Reported symptoms improved subsequently.The sixmonth follow up revealed that the hoarseness had resolved within four weeks of the reduction procedure.CONCLUSION Symptoms of arytenoid cartilage dislocation are difficult to identify in the ICU leading to missed or delayed diagnosis among patients.

关 键 词：Arytenoid cartilage dislocation Intensive care unit Tracheal intubation Persistent hoarseness Risk factors Case report 

分 类 号：R768[医药卫生—耳鼻咽喉科]