The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were reviewed. The diagnosis was made on the basis of a history of dysphonia following intubation in conjunction with laryngoscopy findings and high-resolution CT imaging. All patients had undergone surgery with the majority (75%) having had abdominal surgery. For each case, two patients matched in type of anaesthesia and surgery were chosen as the control. Age, sex, smoking status, alcohol consumption and operative time had no statistically significant influence on the incidence of postoperative arytenoid dislocation.

By contrast, univariate analysis showed that a low BMI was associated with arytenoid dislocation (p = 0.003). Logistic regression analysis indicated that low BMI was an independent risk factor (p = 0.025).

Although this study is limited by its retrospective nature, low numbers and potential for bias, patients with a low BMI do appear to be more susceptible to arytenoid dislocation. This is possibly due to weaker muscle and ligament stabilisation of the arytenoid secondary to a poorer nutritional status. This risk factor should therefore be considered when evaluating dysphonic patients with a history of recent surgery, and also borne in mind when performing rigid endoscopy procedures on the slim.

BMI may be the risk factor for arytenoid dislocation caused by endotracheal intubation: a retrospective case-control study.
Lou Z, Yu X, Li Y, et al.
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Christopher Burgess

Musgrove Park Hospital, Taunton, UK.

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