• Lingeer Wu, Le Shen, Yuelun Zhang, Xiuhua Zhang, and Yuguang Huang.
• Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
• BMC Anesthesiol. 2018 May 31; 18 (1): 59.

BackgroundsArytenoid dislocation (AD) is a rare but severe complication after general anesthesia with endotracheal intubation. We conducted a case-control study at Peking Union Medical College Hospital to identify risk factors associated with AD, including the use of an intubation stylet.MethodsPatients who experienced AD were matched 1:3 with controls based on gender, age and type of surgery. Multiple conditional logistic regression was performed to determine associations between potential risk factors and AD.ResultsTwenty-six AD cases were retrospectively identified from 2004 through 2016. On average, arytenoid dislocation occurred in 2 cases per year, with an incidence of 0.904/100,000 (approximately 0.01%). The 26 patients who experienced AD and 78 matched control patients were enrolled in this study. All enrolled patients underwent endotracheal intubation, and a stylet was used for intubation for 38.5% (10/26) of the AD patients and 64.1% (50/78) of the controls (OR = 0.23, 0.07-0.74). A higher incidence of AD was significantly associated with longer duration of operation (OR = 1.74, 1.23-2.47).ConclusionsThe use of an intubation stylet for endotracheal intubation appears to protect against AD. Prolonged operation time increases the risk of AD. These factors should be considered when assessing the risks of AD associated with endotracheal intubation and in efforts to avoid this complication.

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