Larynx and airway: arytenoid dislocation: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Larynx and airway: arytenoid dislocation

Sample item

After a difficult intubation, a patient has persistent hoarseness and a breathy voice. Laryngoscopy shows an immobile left vocal cord with a tilted arytenoid, and laryngeal electromyography is normal. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Arytenoid dislocation

A traumatic intubation can dislocate the cricoarytenoid joint, immobilising the cord with a mechanical rather than neurological cause. Normal laryngeal electromyography separates it from nerve palsy. Early closed reduction under anaesthesia gives the best result.

Option by option

  • A. Recurrent laryngeal nerve palsy

    Recurrent laryngeal nerve palsy would show denervation changes on electromyography.

  • B. Vocal fold granuloma

    A granuloma is a mass at the vocal process and does not immobilise the arytenoid.

  • C. Arytenoid dislocation (correct)

    Correct. A mechanically fixed cord with normal electromyography after intubation is arytenoid dislocation.

  • D. Laryngeal web

    A laryngeal web is a membrane across the glottis, congenital or post-traumatic, with normal cord movement behind it.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Arytenoid dislocation. A traumatic intubation can dislocate the cricoarytenoid joint, immobilising the cord with a mechanical rather than neurological cause.

Why is "Recurrent laryngeal nerve palsy" not the answer?

Recurrent laryngeal nerve palsy would show denervation changes on electromyography.

Why is "Vocal fold granuloma" not the answer?

A granuloma is a mass at the vocal process and does not immobilise the arytenoid.

Why is "Laryngeal web" not the answer?

A laryngeal web is a membrane across the glottis, congenital or post-traumatic, with normal cord movement behind it.

What concept does this question test?

It tests Larynx and airway: arytenoid dislocation in ENT. Normal laryngeal electromyography separates it from nerve palsy. Early closed reduction under anaesthesia gives the best result.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Larynx and airway: arytenoid dislocation?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.