eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Laryngology

Arytenoid Fixation: Follow-up

Author: Robert A Buckmire, MD, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of North Carolina; Chief, Division of Voice and Swallowing Disorders, Director, University of North Carolina Voice Center
Coauthor(s): Paul C Bryson, MD, Clinical Fellow, Center for Laryngeal Surgery & Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School
Contributor Information and Disclosures

Updated: May 19, 2009

Outcome and Prognosis

The outcome and prognosis of cricoarytenoid (CA) fixation depends entirely on the etiology. However, given the relative infrequency of this diagnosis, it is not surprising that the literature contains no reports of clinical outcomes from large series of patients grouped by specific etiology and treatment strategies.

Future and Controversies

Given the infrequent reports of this entity, a routine workup of vocal-fold immobility is appropriate when it is encountered. Of no surprise, standard etiology-based treatment protocols for arytenoid fixation have yet to be established. Increased awareness of this diagnosis and careful attention to the natural history of patients ideally guide the physicians' therapeutic care plan.

The relationship of prolonged joint immobility to joint fixation is a disputed point. Intuition and reason suggest that prolonged immobility may result in cricoarytenoid (CA) joint ankylosis, as it does in other diarthrodial joints. However, histologic studies have failed to demonstrate this phenomenon in the cricoarytenoid (CA) joint. Possible reasons for this inconsistency may include the non–weight-bearing status of these joints and their potential for low-amplitude passive motion with respiratory airflow.

 


More on Arytenoid Fixation

Overview: Arytenoid Fixation
Workup: Arytenoid Fixation
Treatment: Arytenoid Fixation
Follow-up: Arytenoid Fixation
Multimedia: Arytenoid Fixation
References
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References

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  2. Schaefer SD, Close LG, Brown OE. Mobilization of the fixated arytenoid in the stenotic posterior laryngeal commissure. Laryngoscope. Jun 1986;96(6):656-9. [Medline].

  3. Ejnell H, Bake B, Mansson I, et al. New mobilization and laterofixation procedure for cricoarytenoid joint ankylosis in rheumatoid arthritis. Ann Otol Rhinol Laryngol. Sep-Oct 1985;94(5 Pt 1):442-4. [Medline].

  4. Cummings CW, Redd EE, Westra WH, Flint PW. Minimally invasive device to effect vocal fold lateralization. Ann Otol Rhinol Laryngol. Sep 1999;108(9):833-6. [Medline].

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Further Reading

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Keywords

arytenoid fixation, arytenoid, cricoarytenoid fixation, cricoarytenoid, CA fixation, cricoarytenoid ankylosis, CA ankylosis, arytenoid ankylosis, cricoarytenoid joint fixation, CA joint fixation, cricoarytenoid joint

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Contributor Information and Disclosures

Author

Robert A Buckmire, MD, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of North Carolina; Chief, Division of Voice and Swallowing Disorders, Director, University of North Carolina Voice Center
Robert A Buckmire, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and National Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Paul C Bryson, MD, Clinical Fellow, Center for Laryngeal Surgery & Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School
Paul C Bryson, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, Phi Beta Kappa, and Triological Society
Disclosure: Nothing to disclose.

Medical Editor

John Schweinfurth, MD, Associate Professor, Department of Otolaryngology, University of Mississippi Medical Center
John Schweinfurth, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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