title: Characteristics of vocal fold immobility following endotracheal intubation.
abstract: OBJECTIVE
  We investigated the clinical and laryngeal electromyography (LEMG) characteristics and the outcome of closed reduction of arytenoid cartilage dislocation in patients with vocal fold immobility (VFI) following endotracheal intubation.
  
  
  METHODS
  Sixty patients with VFI following endotracheal intubation were included. Closed reduction was performed under local anesthesia in 54 cases. Another 6 patients did not undergo an intervention. Laryngeal behaviors and voice function were evaluated. Forty-five patients underwent LEMG testing.
  
  
  RESULTS
  All patients complained of persistent hoarseness immediately following surgery. The LEMG results for 29 of 45 patients showed normal patterns (15 cases) or mildly abnormal patterns (14 cases) on the affected side. Sixteen cases displayed apparent abnormal LEMG patterns on the affected side. The voices of all 54 patients improved after reduction. The movement of the affected vocal folds recovered to normal in 51 cases. One month after reduction, neuromuscular function had improved in 29 of 30 cases.Among the 6 patients who did not undergo intervention, 3 had normal or slightly hoarse voices, and 3 experienced moderate hoarseness.
  
  
  CONCLUSIONS
  Vocal fold immobility following endotracheal intubation is typically caused by arytenoid dislocation. Some instances were accompanied by an abnormality of the recurrent laryngeal nerve. A timely closed arytenoid reduction should be performed to restore patients' normal voices and vocal fold mobility. Our reduction technique under local anesthesia can be performed easily and obtains satisfactory outcomes within 6 weeks after endotracheal intubation.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Xu
authors.forename: Demin
authors.initials: D
authors.lastname: Han
authors.forename: Rong
authors.initials: R
authors.lastname: Hu
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
mesh_terms: D001193:Arytenoid Cartilage / Q000503:physiopathology; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007821:Laryngeal Muscles / Q000294:innervation; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology*; D014833:Voice Quality