Closed reduction for arytenoid dislocation under local anesthesia

Abstract

Conclusion: Closed reduction under local anesthesia continues to be an effective and well-tolerated method for treating arytenoid dislocation. Bilateral arytenoid dislocation is an uncommon occurrence, and the principles of management are the same as for unilateral dislocation. Objectives: To evaluate the treatment outcomes of closed reduction for arytenoid dislocation under local anesthesia and to conduct an exhaustive review of the literature on bilateral arytenoid dislocation. Methods: Thirty-three patients with arytenoid dislocation were treated with closed reduction under local anesthesia. Arytenoid motion, GRBAS (grade, roughness, breathiness, asthenia, strain), maximum phonation time (MPT), self-assessed Voice Handicap Index (VHI), and acoustic voice analysis were used to evaluate the clinical outcomes. Results: Following closed reduction, 33 patients were divided into a ‘satisfied’ group (n = 26) and a ‘dissatisfied’ group (n = 7). In the ‘satisfied’ group, G, R, B, A, MPT, VHI, jitter%, shimmer%, normalized noise energy (NNE), and noise-to-harmonic ratio (NHR) were significantly improved compared with measurements taken before closed reduction (p < 0.05). The results for F0 and S score were not significantly different. In the ‘dissatisfied’ group, VHI, MPT, F0, and shimmer% were not significantly different 1 month after reduction. However, statistically significant change was observed in jitter% and NHR.

Keywords:

• Arytenoid cartilage
• endoscopic assessment
• hoarseness
• vocal fold movement
• voice outcomes

Acknowledgments

The authors would like to graciously thank Yi Zhang for her assistance in collecting acoustic data and Shenjiang Wang for his help in completing high-resolution CT examination. This study was supported by the Shanghai Municipal Science and Technology Foundation (14DZ1940702 [C. S. W]) and the Key Project of Traditional Chinese Medicine of the Shanghai Science and Technology Commission (12401902300 [C. S. W]).

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.