Arytenoid cartilage dislocation after tracheal intubation with the McGRATH MAC video laryngoscope: a single-center case series of six patients

Background Arytenoid cartilage dislocation is a rare complication of tracheal intubation. Although video laryngoscopy is widely used, single-device case series of this complication are scarce. Case presentation Among 21,250 tracheal intubations using the McGRATH MAC video laryngoscope at a single center, six patients developed arytenoid dislocation (incidence 0.03%). Four dislocations were anterior, two posterior, four left-sided, one right-sided, and one bilateral. Five intubations were documented as easy and completed at the first attempt without additional maneuvers. One required backward–upward–rightward pressure (BURP). The train-of-four count at intubation was zero in all five measured cases; five operations exceeded 3 h. All patients underwent closed reduction. The patient with bilateral dislocation required tracheostomy, whereas the other five improved/resolved. Conclusions Arytenoid cartilage dislocation may occur even after video laryngoscopic intubation documented as easy and despite a peripheral train-of-four count of zero. Early otolaryngological evaluation of postoperative hoarseness and routine archiving of video laryngoscopic recordings are therefore important.