Perioperatively, a globular mass was observed arising from both false vocal folds, completely filling the glottis and extending to the arytenoids
, supraglottis, and paraglottic space.
The chondrification of the cricoids cartilage is well advanced than that of the thyroid cartilages and thyroid cartilages chondrify earlier to arytenoids
. So developmental gradient of the cartilages is caudo-cranial.
The amount of resting muscle tone in our patient was insignificant because passive motion of the arytenoids
(when palpated separately) was easily demonstrated, indicating that the cricoarytenoid joint itself was not fixed.
Prescott advised surgeons to focus on three supraglouic elements during the physical examination: the epiglottis, the aryepiglottic folds, and the mucosa over the corniculate cartilages on the arytenoids
. (4) He found an omega-shaped epiglottis in 27 patients (67.5%), with epiglottal prolapse into the laryngeal inlet in 13 patients (32.5%).
The patient underwent a supracricoid partial laryngectomy with cricohyoidoepiglottopexy, which preserved the arytenoids
, and a selective bilateral dissection from levels II through V, which preserved both jugular veins and the XIth cranial nerve.
This can result in thyroid cartilage fracture, mucosal disruption, edema, arytenoid
dislocation, and/or torn laryngeal ligaments.
The hypopharynx includes the left and right piriform sinuses, which expand around the sides of the larynx and lie between the larynx and the thyroid cartilage; the lateral and posterior hypopharyngeal walls; and the postcricoid region extending from the level of the arytenoid
cartilages to the inferior border of the cricoid cartilage.
The most common finding was seen in posterior part of larynx - arytenoids
and inter arytenoid
region and posterior part of vocal cords [Table 2].
Even though I were able to introduce the fiberscope into the trachea, I were unable to perform tracheal intubation as I could not pass the tip of the endotracheal tube beyond the arytenoids
Fiber optic laryngoscopic examination showed fullness and inflamed pyriform fossa bilaterally with inflamed arytenoids
Posteriorly, the limit of resection passes in front of the arytenoids
, sectioning the ventricular and aryepiglottic folds.