Low BMI May Be The Risk Factor For Arytenoid Dislocation Caused By Endotracheal Intubation:A Retrospective Case-control Study

Objective:To investigate the risk factors for postoperative arytenoid dislocation.Methods:From September 2014 to September 2016,the records of 28 patients with a history of postoperative arytenoid dislocation in our hospital were reviewed.Patients matched in type of anaesthesia and surgery were chosen as the control(n=56).Recorded data for all patients were demographics,smoking status,alcoholic status,operation time and anaesthesia related risk factors.For arytenoid dislocation cases,the incidences of the left and right arytenoid dislocation were further analyzed.Categorical variables were presented as frequencies and percentages,and were compared using the Chi-squared test.Continuous variables were expressed as means±SD and compared using the Student's unpaired t-test.To determine the predictors of arytenoid dislocation,a logistic regression model was used for multivariate analysis.Statistical significance was indicated by p<0.05.Results:Twenty-eight patients demonstrating postoperative arytenoid dislocation(ten women and eighteen men)were included,with a mean age of 55± 12 years.Sixteen patients(57.14%)had left arytenoid dislocation and twelve(42.86%)had right arytenoid dislocation.Univariate analysis indicated that BMI(body mass index)was associated with arytenoids dislocation(p<0.01),and logistic regression analysis showed that BMI(P=0.048)was an independent risk factor for postoperative arytenoiddislocation.BMI<21.5 kg/m2 group among the men was statistically significant difference with group BMI?21.5 kg/m;BMI<20.5 kg/m2 group among the women was statistically significant difference with group BMI>20.5 kg/m.Conclusions:1.Low BMI might be the independent risk factor for postoperative arytenoid dislocation.Male with BMI<21.5 kg/m2 and female with BMI<20.5 kg/m2 are more susceptible to arytenoid dislocation.2.Cricoarytenoid joint three-dimensional reconstruction based on CT can diagnose vocal cord paralysis and arytenoid dislocation.3.Closed reduction under local anesthesia is an effective and safe procedure.