Lombardi Rafael A., Arthur Mary E.
University of Nebraska Medical Center
Augusta University
Arytenoid subluxation is a rare but clinically significant complication of airway manipulation, capable of causing persistent voice changes and functional impairment. The condition involves partial displacement of the arytenoid cartilage within the cricoarytenoid joint. This entity is distinct from complete arytenoid dislocation, which entails total separation of the cartilaginous surfaces. Although the terms "subluxation" and "dislocation" are often used interchangeably in clinical practice, precise differentiation is essential for diagnostic accuracy and treatment planning. Contemporary evidence suggests that arytenoid subluxation may be more common than previously recognized. Recent data indicate a pooled incidence of 0.093% (confidence interval: 0.045-0.14%) among patients undergoing endotracheal intubation. This update reflects both improved diagnostic techniques and heightened clinical awareness. The discrepancy between historical and contemporary incidence rates likely results from underdiagnosis due to confusion with vocal fold immobility from other causes, such as recurrent laryngeal nerve (RLN) paralysis. Recent advances in diagnostic imaging, particularly dynamic computed tomography (CT) and ultrasonography, have enhanced the ability to diagnose and characterize arytenoid subluxation accurately. Treatment strategies have evolved, with evidence supporting early intervention and specific techniques that optimize patient outcomes.
杓状软骨半脱位是气道操作中一种罕见但具有临床意义的并发症，可导致持续性声音改变和功能障碍。该病症涉及杓状软骨在环杓关节内的部分移位。这种情况不同于完全性杓状软骨脱位，后者需要软骨表面完全分离。尽管在临床实践中“半脱位”和“脱位”这两个术语经常互换使用，但精确区分对于诊断准确性和治疗计划至关重要。当代证据表明，杓状软骨半脱位可能比以前认识到的更为常见。最近的数据显示，在接受气管插管的患者中，合并发病率为0.093%（置信区间：0.045-0.14%）。这一更新既反映了诊断技术的改进，也反映了临床意识的提高。历史发病率与当代发病率之间的差异可能是由于与其他原因导致的声带固定（如喉返神经麻痹）混淆而导致诊断不足所致。诊断成像的最新进展，特别是动态计算机断层扫描（CT）和超声检查，提高了准确诊断和表征杓状软骨半脱位的能力。治疗策略已经演变，有证据支持早期干预和优化患者预后的特定技术。
