Abstract

The cricoarytenoid joints are frequently asymptomatically involved in rheumatoid arthritis with a severe course. At least the symptoms recede into the background compared with the other complaints. Signs of obstructive laryngeal changes are often falsely interpreted. Dangerous respiratory tract obstructions may be initiated by bacterial infections of the larynx and mechanical laryngeal changes or by the acute exacerbation of the arthritis. The clinical diagnosis of CA-arthritis is supplemented by laryngoscopic, radiologic and computertomographic techniques. Simple clinical examination methods only are relevant for routine or screening tests. The differential diagnosis requires consideration of neurogenic, traumatic, infectious or neoplastic and psychosomatic diseases. Corticosteroids and non-steroidal antiinflammatory drugs are of doubtful value in treatment. Physical conservative methods are usually sufficiently effective for prophylaxis and control of symptoms. In an emergency tracheotomy can be life-saving. Arytenoidectomy or mobilisation and lateral fixation of the vocal chord are considered definitive treatment.