Arytenoid Cartilages

cartilagines arytenoideae

The arytenoid cartilages are paired pyramid-shaped cartilages sitting on the superior posterior surface of the cricoid lamina at the cricoarytenoid joints. Each has a vocal process projecting anteriorly (providing the posterior attachment of the vocal cord and the vocalis muscle) and a muscular process projecting posterolaterally (providing attachment for the posterior and lateral cricoarytenoid muscles). The arytenoids pivot and glide on the cricoid to open and close the glottis.

Region: Neck

Clinical Relevance

Clinical Notes

The arytenoid cartilages are the principal moving parts of the glottis. Cricoarytenoid joint fixation (from rheumatoid arthritis, post-intubation scarring, or cricoarytenoid dislocation) produces bilateral vocal cord fixation with airway compromise mimicking bilateral vocal cord palsy. Arytenoid dislocation from difficult intubation produces hoarseness, odynophagia, and unilateral vocal cord immobility. Arytenoidectomy (laser or open) is performed for bilateral vocal cord palsy to widen the glottis. Arytenoid adduction surgery repositions the cartilage in unilateral palsy.

Pathology

Common Injuries & Conditions

Arytenoid Dislocation from Difficult Intubation

Traumatic laryngoscopy displaces the arytenoid cartilage anteriorly or posteriorly from the cricoarytenoid joint, producing persistent hoarseness, aspiration, and unilateral fixed vocal cord after a difficult intubation, diagnosed by laryngoscopy and CT, managed by early closed reduction under general anaesthesia.