기관내 삽관에 의한 윤상피열연골의 아탈구

Abstract

Arytenoid cartilage displacement (dislocation and subluxation) following endotracheal intubation is a rare event. Recognition of its occurrence and subsequent treatment are important to prevent longterm consequences. A 44-year-old healthy woman was admitted for total thyroidectomy and isthmusectomy. Anesthesia was induced and a number 7 cuffed endotracheal tube with a stylet was inserted under direct vision after two unsuccessful attempts without a stylet. The trachea was extubated without any difficulty in the recovery room after the surgery. About 8 hours later, the patient complained odynophagea, dysphagea, dysphonia and hoarseness. Indirect laryngoscopy and videolaryngotelescopy at the otolaryngology department revealed anterior subluxation of both cricoarytenoid cartilages with poor mobility and edema on the vocal cords. A follow-up indirect laryngoscopic examination performed after 5 days of conservative trearment showed return of the voice quality with slightly reduced mobility on the left vocal cord.