全麻腹腔镜胃肠手术后杓状软骨脱位3例的原因分析及预防

doi:10.3760/cma.j.cn441417-20240909-02027

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (2): 313-315.DOI: 10.3760/cma.j.cn441417-20240909-02027

全麻腹腔镜胃肠手术后杓状软骨脱位3例的原因分析及预防

都淑萍¹ 周业建¹ 王志娟²

¹山东大学附属威海市立医院麻醉科，威海 264200；²南方医科大学珠江医院《中华神经医学杂志》编辑部，广州 510282

收稿日期:2024-09-09 出版日期:2025-01-15 发布日期:2025-01-20
通讯作者: 王志娟，邮箱：574516185@qq.com
基金资助:
广东省科技计划（2017A030303020）

Cause analysis and prevention of arytenoid cartilage dislocation in three cases after laparoscopic gastrointestinal surgery under general anaesthesia

Du Shuping¹, Zhou Yejian¹, Wang Zhijuan²

¹Department of Anaesthesiology, Weihai Municipal Hospital, Shandong University, Weihai 264200, China; ²Editorial Department of Chinese Journal of Neuromedicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China

Received:2024-09-09 Online:2025-01-15 Published:2025-01-20
Contact: Wang Zhijuan, Email: 574516185@qq.com
Supported by:
Plan of Science and Technology in Guangdong (2017A030303020)

摘要/Abstract

摘要：

杓状软骨脱位（arytenoid cartilage dislocation，ACD）是气管插管或喉钝挫伤的一种罕见且经常被忽视的并发症，最常见的症状是持续性声音嘶哑。咽喉部置管、检查、监测、治疗等操作均是引发ACD的潜在因素。本文报道山东大学附属威海市立医院3例患者，于全麻腹腔镜胃肠手术后出现声嘶、呛咳、发音困难等症状，雾化治疗无效，请耳鼻喉医生会诊，确诊为ACD。经耳鼻喉医生手法复位和语音训练，患者康复。本文就ACD的发生原因和防治措施进行了分析。

关键词:

杓状软骨脱位, 原因分析, 预防

Abstract:

Arytenoid cartilage dislocation (ACD) is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma. Its most common symptom is persistent hoarseness. Procedures, such as pharyngeal intubation, examination, monitoring, and treatment, are potential factors that can lead to ACD. This article reports three cases at Weihai Municipal Hospital, Shandong University; the patients occurred ACD following laparoscopic gastrointestinal surgery under general anesthesia; the patients exhibited symptoms such as hoarseness, choking cough, and dysphonia after surgery; nebulization treatment was ineffective; otolaryngologists were consulted, and the patients were diagnosed as ACD; the patients recovered after manipulative repositioning and voice training by the otolaryngologists. In this paper, the causes and prevention measures of ACD are analyzed.

Key words:

Arytenoid cartilage dislocation, Cause analysis, Prevention

都淑萍周业建王志娟.

全麻腹腔镜胃肠手术后杓状软骨脱位3例的原因分析及预防 [J]. 国际医药卫生导报, 2025, 31(2): 313-315.

Du Shuping, Zhou Yejian, Wang Zhijuan.

Cause analysis and prevention of arytenoid cartilage dislocation in three cases after laparoscopic gastrointestinal surgery under general anaesthesia [J]. International Medicine and Health Guidance News, 2025, 31(2): 313-315.

参考文献

[1] Yan WQ, Li C, Chen Z. Delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the intensive care unit: a case report [J]. World J Clin Cases, 2022, 10(15): 5119-5123. DOI: 10.12998/wjcc.v10.i15.5119.
[2] Frosolini A, Marioni G, Maiolino L, et al. Current management of arytenoid sub-luxation and dislocation [J]. Eur Arch Otorhinolaryngol, 2020, 277(11): 2977-2986. DOI: 10.1007/s00405-020-06042-3.
[3] Wu L, Shen L, Zhang Y, et al. Association between the use of a stylet in endotracheal intubation and postoperative arytenoid dislocation: a case-control study [J]. BMC Anesthesiol, 2018, 18(1): 59. DOI: 10.1186/s12871-018- 0521-9.
[4] Norris BK, Schweinfurth JM. Arytenoid dislocation: an analysis of the contemporary literature [J]. Laryngoscope, 2011, 121(1): 142-146. DOI: 10.1002/lary.21276
[5] Yan W, Chen Z, Dong W, et al. High prevalence of postoperative arytenoid dislocation in patients undergoing liver transplantation: a case-control study [J]. Medicine (Baltimore), 2023, 102(34): e34771. DOI: 10.1097/MD.0000000000034771.
[6] Yamanaka H, Hayashi Y, Watanabe Y, et al. Prolonged hoarseness and arytenoid cartilage dislocation after tracheal intubation [J]. Br J Anaesth, 2009, 103(3): 452-455. DOI: 10.1093/bja/aep169.
[7] Lou Z, Yu X, Li Y, et al. BMI may be the risk factor for arytenoid dislocation caused by endotracheal intubation: a retrospective case-control study [J]. J Voice, 2018, 32(2): 221-225. DOI: 10.1016/j.jvoice.2017.05.010.
[8] Mallon AS, Portnoy JE, Landrum T, et al. Pediatric arytenoid dislocation: diagnosis and treatment [J]. J Voice, 2014, 28(1): 115-122. DOI: 10.1016/j.jvoice.2013.08.016.
[9] Okazaki Y, Ichiba T, Higashi Y. Unusual cause of hoarseness: arytenoid cartilage dislocation without a traumatic event [J]. Am J Emerg Med, 2018, 36(1): 172.e1-172.e2. DOI: 10.1016/j.ajem.2017.10.041.
[10] Jang EA, Yoo KY, Lee S, et al. Head-neck movement may predispose to the development of arytenoid dislocation in the intubated patient: a 5-year retrospective single-center study [J]. BMC Anesthesiol, 2021, 21(1): 198. DOI: 10.1186/s12871-021-01419-1.
[11] Fujii-Abe K, Ikeda M, Yajima M, et al. A case of anterior arytenoid cartilage dislocation during nasal tracheal intubation using an indirect video laryngoscope [J]. Anesth Prog, 2023, 70(4): 191-193. DOI: 10.2344/837325.
[12] Rubin AD, Hawkshaw MJ, Moyer CA, et al. Arytenoid cartilage dislocation: a 20-year experience [J]. J Voice, 2005, 19(4): 687-701. DOI: 10.1016/j.jvoice.2004.11.002.
[13] Ferraro EL, Blunck CK, Benninger MS, et al. Scoping review of surgical rehabilitation of post intubation phonatory insufficiency [J]. Laryngoscope, 2024, 134(5): 2048-2058. DOI: 10.1002/lary.31138.
[14] Saravanan R, Parameshwaran M, Nivedita K, et al. Cricoarytenoid subluxation presenting as vocal cord palsy following endotracheal intubation - a case report [J]. Saudi J Anaesth, 2022, 16(2): 243-245. DOI: 10.4103/sja.sja_777_21.
[15] Afonso A, Woo P, Reed A. Arytenoid dislocation following upper gastrointestinal endoscopy [J]. Endoscopy, 2011, 43 Suppl 2 UCTN: E368. DOI: 10.1055/s-0030-1256690.
[16] Niwa Y, Nakae A, Ogawa M, et al. Arytenoid dislocation after cardiac surgery [J]. Acta Anaesthesiol Scand, 2007, 51(10): 1397-1400. DOI: 10.1111/j.1399-6576.2007. 01384.x.
[17] Mikuni I, Suzuki A, Takahata O, et al. Arytenoid cartilage dislocation caused by a double-lumen endobronchial tube [J]. Br J Anaesth, 2006, 96(1): 136-138. DOI: 10.1093/bja/aei281.
[18] Hung KC, Chen YT, Chen JY, et al. Clinical characteristics of arytenoid dislocation in patients undergoing bariatric/metabolic surgery: a STROBE-complaint retrospective study [J]. Medicine (Baltimore), 2019, 98(17): e15318. DOI: 10.1097/MD.0000000000015318.
[19] Szigeti CL, Baeuerle JJ, Mongan PD. Arytenoid dislocation with lighted stylet intubation: case report and retrospective review [J]. Anesth Analg, 1994, 78(1): 185-186. DOI: 10.1213/00000539-199401000-00034.
[20] 刘敬,邓蔚,杨长亮,等. 经支撑喉镜下杓状软骨拨动术治疗环杓关节脱位的临床效果[J]. 精准医学杂志,2024,39(5):397-399, 403. DOI:10.13362/j.jpmed.202405005.
[21] Lou Z, Li X, Jiang JJ, et al. Modified laryngeal forceps for arytenoid cartilage dislocation caused by endotracheal intubation: a retrospective case-control pilot study [J]. Ear Nose Throat J, 2023, 1455613231205529. DOI: 10.1177/01455613231205529.
[22] Shen L, Wang W T, Yu X R, et al. Evaluation of risk factors for arytenoid dislocation after endotracheal intubation: a retrospective case-control study [J]. Chin Med Sci J, 2014, 29(4): 221-224. DOI: 10.1016/s1001-9294(14)60074-2.
[23] 肖建英, 陈林英, 张勇. 杓状软骨脱位病因学的研究进展 [J]. 江苏医药, 2022, 48(11): 1172-1175. DOI: 10.19460/j.cnki.0253-3685.2022.11.025.
[24] Tan PH, Hung KC, Hsieh SW, et al. Large-bore calibrating orogastric tube and arytenoid dislocation: a retrospective study [J]. Br J Anaesth, 2016, 116(2): 296-298. DOI: 10.1093/bja/aev463.
[25] 龚桃根, 马玲国, 刘倩. 支撑喉镜下杓状软骨复位术治疗环杓关节脱位的疗效观察 [J]. 听力学及言语疾病杂志, 2022, 30(4): 426-428. DOI:10.3969/j.issn.1006-7299.2022. 04.019.

全麻腹腔镜胃肠手术后杓状软骨脱位3例的原因分析及预防

Cause analysis and prevention of arytenoid cartilage dislocation in three cases after laparoscopic gastrointestinal surgery under general anaesthesia

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	李轶晓庞海燕赵景芹曹飞. 预防性护理对乌司他丁治疗重症急性胰腺炎患者肝功能及血清炎症因子水平的影响 [J]. 国际医药卫生导报, 2025, 31(1): 117-121.
[2]	王宇威李瑞刘超梁葵香. 妊娠相关静脉血栓栓塞症的诊断和防治策略研究进展 [J]. 国际医药卫生导报, 2024, 30(6): 940-945.
[3]	李丹丹王欢欢姬响华蔻香草罗冷孙羽燕. 超声指导下的护理方案预防ECMO运转期患儿压疮的效果 [J]. 国际医药卫生导报, 2024, 30(4): 559-563.
[4]	石姗平闫琴琴覃钊吴雪. 质子泵抑制剂在颅脑损伤应激性溃疡中的应用与研究进展 [J]. 国际医药卫生导报, 2024, 30(23): 3929-3932.
[5]	胡蝶张久霞赵一吴兰艳. 基于循环管理法的质控管理对医务人员手卫生改善及医院感染预防的效果观察 [J]. 国际医药卫生导报, 2024, 30(22): 3880-3884.
[6]	赵丹徐传伟周芳芳陈德仁林颖汪燕玲. 长疗程逆灸对急性脑梗死患者预防卒中后抑郁的效果观察 [J]. 国际医药卫生导报, 2024, 30(2): 239-243.
[7]	张峥璐宁婕高瑞江刘国娟乌依罕. 呼和浩特市某社区居民颈动脉斑块发生率及其危险因素研究 [J]. 国际医药卫生导报, 2024, 30(13): 2169-2174.
[8]	何海燕芦菲. 尼可地尔联合水化预防冠状动脉介入术后对比剂肾病的临床疗效 [J]. 国际医药卫生导报, 2023, 29(24): 3645-3648.
[9]	黄韵诗杨燕君吴少敏吴嘉婷. 广州市番禺区儿童家长水痘疫苗犹豫现状及其影响因素分析 [J]. 国际医药卫生导报, 2023, 29(24): 3732-3735.
[10]	骆美仪李红霞. 管道滑脱风险评估表在ICU非计划性拔管防范中的应用 [J]. 国际医药卫生导报, 2023, 29(21): 3112-3115.
[11]	潘海萍何平. 示警性预防护理对重症肺炎患者风险系数及临床结局的影响 [J]. 国际医药卫生导报, 2023, 29(17): 2494-2498.
[12]	徐希李向阳张波向远刚阳攀张振声许传亮. 预防膀胱癌患者发生静脉血栓栓塞的研究进展 [J]. 国际医药卫生导报, 2023, 29(15): 2073-2076.
[13]	毛晓芬, 杨波, 唐莉, 龚婷婷, 左慧, 吴丽美. 某医院工作人员接种新冠灭活疫苗的回顾性研究[J]. 国际医药卫生导报, 2022, 28(4): 577-581.
[14]	袁琛烨, 周之音. 基于智慧医疗系统的管理模式预防乳腺癌患者术后淋巴水肿的效果观察 [J]. 国际医药卫生导报, 2022, 28(3): 336-340.
[15]	黄素嫦温桂香余静周敏韩治军. 4R危机管理理论在脓毒症患者胃肠功能障碍预防管理中的应用[J]. 国际医药卫生导报, 2022, 28(22): 3144-3148.