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A Case of Anterior Arytenoid Cartilage Dislocation During Nasal Tracheal Intubation Using an Indirect Video Laryngoscope
Keiko Fujii-AbeDDS, PhD,
Maho IkedaDDS,
Manami YajimaDDS, PhD, and
Hiroshi KawaharaDDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 70: Issue 4
Online Publication Date: Jan 15, 2024
DOI: 10.2344/837325
Page Range: 191 – 193

glottis without touching the vocal cords or other laryngeal structures (arytenoid notch, corniculate tubercle, cuneiform tubercle, etc). No physical movement of the patient’s head or neck or “bucking” occurred during surgery, and no similarly notable findings were observed during emergence or following extubation. The surgery lasted 5 hours and 59 minutes, and the total anesthesia time was 6 hours and 52 minutes. Upon the patient’s return to her room, she began to complain immediately of hoarseness, a sore throat, and odynophagia. The patient’s sore throat was

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; Deviation of the tongue to the right side and dysphonia.
Shadaab Mumtaz,
Alastair Henry, and
Mark Singh

Deviation of the tongue to the right side and dysphonia.

Tapia's Syndrome
Shadaab MumtazMFDS RCPS(Glasg),
Alastair HenryMRCS, and
Mark SinghFRCS (OMFS)
Article Category: Research Article
Volume/Issue: Volume 65: Issue 2
Online Publication Date: Jan 01, 2018
DOI: 10.2344/anpr-65-04-06
Page Range: 129 – 130

Figure 2.; Laryngeal Anatomy and the Video Laryngoscope Tip (A) The tip of the video laryngoscope blade may have been initially inserted too deeply and compressed the posterior aspect of the cricoarytenoid joint. (B) A 3-D diagram of the laryngeal structures illustrating where a strong force is presumed to have been exerted on the left (black circle).
Keiko Fujii-Abe,
Maho Ikeda,
Manami Yajima, and
Hiroshi Kawahara
Figure 2.
Figure 2.

Laryngeal Anatomy and the Video Laryngoscope Tip

(A) The tip of the video laryngoscope blade may have been initially inserted too deeply and compressed the posterior aspect of the cricoarytenoid joint. (B) A 3-D diagram of the laryngeal structures illustrating where a strong force is presumed to have been exerted on the left (black circle).

Figure 1.; Postoperative Computed Tomography Imaging (A) Sagittal view of the left cricoarytenoid joint reveals a gap (red circle) between the arytenoid and cricoid cartilages due to the arytenoid dislocation. (B) Sagittal view of the right cricoarytenoid joint illustrates the arytenoid and cricoid cartilages are contacting (red circle). (C) Axial view shows the left arytenoid cartilage is displaced anteromedially (arrow).
Keiko Fujii-Abe,
Maho Ikeda,
Manami Yajima, and
Hiroshi Kawahara
Figure 1.
Figure 1.

Postoperative Computed Tomography Imaging

(A) Sagittal view of the left cricoarytenoid joint reveals a gap (red circle) between the arytenoid and cricoid cartilages due to the arytenoid dislocation. (B) Sagittal view of the right cricoarytenoid joint illustrates the arytenoid and cricoid cartilages are contacting (red circle). (C) Axial view shows the left arytenoid cartilage is displaced anteromedially (arrow).

A Case of Laryngeal Granuloma Likely Caused by Laryngopharyngeal Reflux Disease Following a Sagittal Split Ramus Osteotomy
Mami NakamuraDDS,
Akio UdaDDS, PhD,
Naokazu KataokaDDS,
Kana NagasakaDDS,
Kazuhisa TamashigeDDS,
Daichi MoriDDS,
Hideo NiwaMD, PhD, and
Koh ShibutaniDDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-02-12
Page Range: 248 – 250

remained comfortable in the early postoperative period without hoarseness or sore throat. Two days after extubation, the patient complained of hoarseness, sore throat, and dyspnea. Two months postoperatively after experiencing varying intensity of symptoms, she was diagnosed in the Otolaryngology Department with laryngeal granuloma of bilateral arytenoid cartilages. No laryngeal nerve damage was found. The otolaryngologist found the presence of gastroesophageal reflux disease (GERD) in the interview, and nonsurgical treatment was selected. Administration of

A Case of Laryngeal Granulomas After Oral and Maxillofacial Surgery With Prolonged Intubation
Masanori TsukamotoDDS, PhD,
Shiori TauraDDS,
Takashi HitosugiDDS, PhD, and
Takeshi YokoyamaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/anpr-68-01-03
Page Range: 94 – 97

Many terms have been used to refer to a laryngeal granuloma, including arytenoid granuloma, vocal process granuloma, or vocal fold granuloma. 2 , 7 , 8 Clinical signs and symptoms of laryngeal granulomas can include dysphonia, hoarseness, sore throat, and dyspnea, which may not manifest until 1–4 months after extubation. 2 , 7 – 9 Common causes include mechanical trauma or irritation from an endotracheal tube (ETT; 23%), excessive vocal straining or overuse (33%), and gastroesophageal reflux disease (30%). 3 Manipulation of the airway during intubation and

Risk Factors for Postoperative Sore Throat After Nasotracheal Intubation
Masanori TsukamotoDDS, PhD,
Shiori TauraDDS,
Sayuri KadowakiDDS, PhD,
Takashi HitosugiDDS, PhD,
Yoichiro MikiPhD, and
Takeshi YokoyamaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 69: Issue 3
Online Publication Date: Oct 06, 2022
DOI: 10.2344/anpr-69-01-05
Page Range: 3 – 8

study was to determine the incidence of and risk factors for postoperative sore throat following nasotracheal intubation for oral and maxillofacial surgery. Secondary aims were to assess the degree and duration of postoperative sore throat and the incidence of hoarseness associated with nasotracheal intubations. We hypothesized that postoperative sore throat is influenced by the intubating conditions and utilized airway devices, especially the use of a fiberoptic scope, which would have higher incidence or more severe sore throat due to difficulty advancing the ETT

Literature Review for Office-Based Anesthesia
Mark A. SaxenDDS, PhD
Article Category: Review Article
Volume/Issue: Volume 70: Issue 1
Online Publication Date: Mar 28, 2023
DOI: 10.2344/1878-7177-70.1.49
Page Range: 49 – 50

Murugaiyan A, Sahoo AK, Rao PB, Misra S. Effect of 5% EMLA cream on postoperative sore throat in adults following general endotracheal anesthesia: a randomized placebo-controlled study. Anesth Analg . 2023;136(2):338–345. doi: 10.1213/ANE.0000000000006269 This study aimed to evaluate the effects of a eutectic mixture of local anesthetics (EMLA) cream applied topically over the endotracheal tube (ETT) cuff on the incidence and severity of postoperative sore throat (POST), cough, and voice hoarseness in adults after surgery. A total of 204

Literature Review for Office-Based Anesthesia
Mark A. SaxenDDS, PhD
Article Category: Book Review
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/0003-3006-68.2.128
Page Range: 128 – 130

the most frequently reported mild injury, with a prevalence of 9 to 84%. Vocal fold hematomas were the most frequently reported moderate injury with a prevalence of 4%. Severe injuries that include subluxation of the arytenoids and vocal fold paralysis were found to be rare (<1%) outcomes. The most prevalent patient complaints were dysphagia (43%), pain (38%), coughing (32%), a sore throat (27%), and hoarseness (27%). Overall, laryngeal injury from short-duration surgical intubation is common and is most often mild. No uniform guidelines for postoperative laryngeal