Cricoarytenoid ankylosis was first called to my attention by the excellent article of Montgomery, Perone, and Schall on that subject. At the time of its publication, I had just seen a case of bilateral abductor paralysis of the larynx of unknown etiology. A review of the clinical findings revealed my diagnostic error.
The diagnosis of bilateral cricoarytenoid ankylosis may be made upon the finding of the following symptoms and signs: (1) A history of dyspnea on inspiration and expiration which is more marked on inspiration. (2) Minimal voice impairment. (3) Mirror laryngoscopy revealing the arytenoids fixed in the mid-line with a typical bowing of the anterior two-thirds on inspiration, as reported by Montgomery et al. (4) Confirmation with direct laryngoscopy showing the arytenoids to be immobile and producing pain on attempting to move them.
The differential diagnosis involves the various causes of bilateral abductor paralysis, and as these are eliminated
REAVES RG. Bilateral Cricoarytenoid Ankylosis: Surgical Treatment. AMA Arch Otolaryngol. 1957;65(6):603–605. doi:10.1001/archotol.1957.03830240059011
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