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RESEARCH - Aggravation of laryngeal RA after use of a laryngeal mask airway

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J Clin Rheumatol. 2006 Jun;12(3):142-4.

Aggravation of laryngeal rheumatoid arthritis after use of a laryngeal mask

airway.

Department of Anesthesiology and Critical Care Medicine, Jichi Medical

School, Kawachi, Tochigi, Japan. miyanohara@...

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.

PMID: 16755245

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16755245

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