Abstract：
This case report describes a right arytenoid dislocation after emergency fiberoptic nasotracheal intubation in a patient with angioedema. The patient returned to the emergency department multiple times with classic symptoms of arytenoid dislocation, complicated by resultant postinjury laryngeal edema and poorly controlled laryngopharyngeal reflux. The arytenoid injury was not initially recognized, which delayed treatment. Several months later, intraoperative assessment was done because of continued symptoms suspicious for laryngeal injury, resulting in a diagnosis of right cricoarytenoid joint fixation resulting from prior intubation trauma. Because of delayed diagnosis and treatment, severe cricoarytenoid joint scarring and fixation prevented repositioning of the arytenoid and improvement in laryngeal function. Discussion of this case includes a review of the anatomy and function of the arytenoid and cricoarytenoid joint, along with factors that increase and decrease joint stability and risk of injury. The etiology of arytenoid dislocation is described, along with suspected mechanisms of injury in anterior vs posterior and right vs left dislocations. Classic symptoms, the importance of early identification, and treatment options are also discussed.
摘要：
此病例报告描述了血管性水肿患者在紧急纤维鼻气管插管后发生的右关节脱位。患者多次返回急诊科，出现典型的关节突脱位症状，并发损伤后喉部水肿和控制不佳的咽喉反流。最初并没有意识到arytenoid损伤，延迟治疗。几个月后,术中评估是由于持续的症状可疑的喉损伤，导致诊断为由于先前的插管创伤而导致的右环关节固定。因为延误了诊断和治疗,严重的环蝶骨关节瘢痕形成和固定阻止了蝶骨的重新定位和喉功能的改善。对这种情况的讨论包括对关节和环关节的解剖结构和功能的回顾，以及增加和减少关节稳定性和损伤风险的因素。描述了Arytenoid脱位的病因，以及前脱位、后脱位和右脱位、左脱位的可疑损伤机制。经典症状,早期识别的重要性，并讨论了治疗方案。
