Mobilization of the fixated arytenoid in the stenotic posterior laryngeal commissure.

Stenosis of the posterior laryngeal commissure with arytenoid fixation following intubation trauma or laryngeal fracture poses a treatment dilemma. Over the past 2 1/2 years we have managed four patients with this problem by mobilization of the fixated cricoarytenoid joint, arytenoid-pharyngeal mucosal advancement flap, brief splinting of the arytenoids in the fully abducted position, and early speech therapy. As of this time, three of the four patients have been both decannulated and have achieved adequate to near normal voices. Most significantly, the previously fixated arytenoids are now mobile, confirming the efficacy of the principles presented herein.