Endoscopic direct laryngoscopy using 700rigid telescope was carried out to examine the supraglottis, vocal cords, valleculae and the
interarytenoid area.
Severe inflammation was observed involving the true vocal folds, subglottis, trachea, and the
interarytenoid region (figure 4, A).
PET/CT imaging showed hypermetabolic focus on left aryepiglottic fold and
interarytenoid area maximum standard uptake values ([SUV.sub.max]): 8.9 without any anatomical correlation.
The vocal cords and
interarytenoid notch could not be visualized.
Floppy epiglottis was visualized, and glottis stenosis with
interarytenoid adhesion was seen.
Direct laryngoscopy was performed, and the foreign body was seen extending just above the vocal folds and in the
interarytenoid space.
On ENT examination, indirect laryngoscopic examination revealed an ulcerative lesion over the epiglottis, arytenoids and
interarytenoid area.
Like other muscles innervated by cranial nerves, the intrinsic laryngeal muscles, for example, the thyroarytenoid that comprises the vocal folds, as well as the muscles that adduct (
interarytenoid and lateral cricoarytenoid), abduct (posterior cricoarytenoid), and lengthen the vocal folds (cricothyroid), are composed of muscle fibers that differ from most abdominal and limb muscle.
While the exposure of the mild and moderate pH levels in the upper airway may contribute to subtle tissue changes (e.g., posterior
interarytenoid edema and erythema or accumulation of endolaryngeal mucous), the potential effects on voice quality, including hoarseness, loss of range, and vocal fatigue, are both highly variable and unpredictable.
The effective medial excursion magnitude of vocal fold produced by the three adductors physiologically is sequentially as following: Rotation effect by lateral cricoarytenoid (LCA), mass or volume effect by thyroarytenoid (TA) and then shift effect by
interarytenoid (IA) muscle.
By the effect of sevoflurane the leech departed from the
interarytenoid region.