Severe airway obstruction caused by laryngeal rheumatoid arthritis

Ankylosis of the cricoarytenoid joints due to rheumatoid arthritis (RA) may cause upper airway obstruction by fixation of the vocal cords in the midline. In early stages, this condition usually results in minor symptoms which are easily overlooked. It may, however, very rapidly, e.g., in association with an upper respiratory tract infection, become life-threatening. It is essential to diagnose this condition early to avoid emergency situations. In 5 patients with classic RA and in one patient with juvenile RA severe laryngeal obstruction was operated on using a new simple technique consisting of a mobilization of the arytenoid cartilages and laterofixation of one of the vocal cords.