Aggravation of laryngeal rheumatoid arthritis after use of a laryngeal mask airway.
We report a case of aggravation of laryngeal rheumatoid arthritis (RA) after the use of a laryngeal mask airway (LMA). The patient was a 55-year-old woman with severe RA who underwent wrist arthrodesis under general anesthesia using a size 3 LMA. A few days after the operation, she reported hoarseness. Inflammation of the arytenoid region and vocal cord immobility were observed by fiberoptic nasolaryngoscopy. Vocal function returned to normal by postoperative day 42 in response to prednisolone therapy. In this case, stridor was misdiagnosed preoperatively, and postoperative symptoms and local findings were probably caused by aggravation of laryngeal RA resulting from substantial compression of the arytenoid region by the LMA. For patients with RA referred for surgery, a careful search for cricoarytenoid arthritis is essential, particularly in those with laryngeal stridor, because it may be aggravated after general anesthesia.
Miyanohara
Toshio
T
Department of Anesthesiology and Critical Care Medicine, Jichi Medical School, Kawachi, Tochigi, Japan. miyanohara@jichi.ac.jp
Igarashi
Takashi
T
Suzuki
Hideo
H
Hirabayashi
Yoshihiro
Y
Seo
Norimasa
N
D001172:Arthritis, Rheumatoid / Q000473:pathology*; D001193:Arytenoid Cartilage / Q000473:pathology; D003413:Cricoid Cartilage / Q000473:pathology; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000473:pathology*; D017214:Laryngeal Masks / Q000009:adverse effects*; D008875:Middle Aged