Utility of Spiral Computed Tomography in the Study of Dislocation of Cricoarytenoid Joint

The cricoarytenoid relationship presented with spiral computed tomography was demonstrated and the reconstruction of arytenoid dislocation was presented by using multiplanar reconstruction algorithms. Fifteen patients with arytenoid dislocation documented by fiberoptic laryngoscopy and strobovideolaryngoscopy and 10 normal persons were displayed by spiral computed tomography (CT). A making design of our own had been used to diagnose arytenoid dislocation on axial CT image. Results showed that dislocation of cricoarytenoid joint was consistently demonstrated on several of the overlapping thin axial reconstructions in each of the 15 patients, in whom asymmetry of the bilateral cricoarytenoid joints was noted on axial images. It was found that on the glottic-fissure level the basal angle on abnormal side was larger in 8 patients than that on the normal side and smaller in 7 patients in patient group, whereas right basal angle was equal to the left in 8 subjects, except 2 in control group. There was statistically significant difference in the number of the equal to two basal angles of glottic fissure between control group and patient group (P<0.025). High-quality sagittal and coronal reconstructive images often were helpful in confirming or clarifying the complex arytenoid orientations. The findings that two-side basal angle was not equal in triangle of glottic fissure can be used as an objective parameter to diagnose arytenoid dislocation. Spiral CT is a useful adjunct in the diagnosis and treatment of dislocation of cricoarytenoid joint.

A Comparative Study on the Close Reduction of Arytenoid Dislocation under Indirectand Direct Laryngoscope

To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation,indirect laryngoscope (IL ) and direct laryngoscope (DL ) were utilized for the closed reduction of the displaced arytenoid under local anesthesia.2 3patients who underwent the reduction for dislocated arytenoid under IL or DL from January1991to June 2 0 0 1were reviewed.The data were collected on the duration of the laryngeal injury,tim es of re- ceiving reduction,side- effects after the treatment and the period for voice to return to normal. The relationship between the duration of the laryngeal lesion and the period of the voice rehabilita- tion was examined.13patients received the reduction under IL and 10 patients under DL .Except the tim es of the reduction,which showed significant difference,no differences were found between IL group and DL group in the course and the period of voice rehabilitation,as well as sore throat after the manipulation.The patients'voice recovery was positively related to their course of dis- ease in both IL and DL group.Itis concluded thatthe recovery of normal voice is obviously affect- ed by the duration of arytenoid dislocation.The reduction under IL is as effective as under DL in the treatment of arytenoid dislocation.Reduction by DL is better suit the patients with long tim e course of disease.