Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.5119
Peer-review started: January 11, 2022
First decision: February 21, 2022
Revised: March 5, 2022
Accepted: March 26, 2022
Article in press: March 26, 2022
Published online: May 26, 2022
Processing time: 133 Days and 2.5 Hours
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.
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 expe
Symptoms of arytenoid cartilage dislocation are difficult to identify in the ICU leading to missed or delayed diagnosis among patients.
Core Tip: We report a case of arytenoid cartilage dislocation in the intensive care unit (ICU). The main reason for delayed diagnosis was difficulty in communicating with the patient, who was under sedation. This resulted in difficulties in early observations of dislocation symptoms. Therefore, patients in the ICU may be at a greater risk for arytenoid cartilage dislocation, and it is difficult to identify these symptoms, leading to missed or delayed diagnosis.