Immobility, fixation, or paralysis of the vocal folds is an ominous sign when encountered in the clinics. This may be due to a variety of diseases, lesions, injuries, or vascular compromise which may affect the integrity and physiologic mechanism of the vocal folds. The common etiologies include infectious processes such as laryngeal or pulmonary tuberculosis (PTB), malignancy or neoplasms, central problems such as cerebrovascular accidents (CVA), stroke and others.1,2,3 The problem should be addressed immediately because this potentially life threatening and imminent narrowing of the glottic opening may lead to respiratory distress. Vocal fold paralysis due to compression of the recurrent laryngeal nerve from PTB and laryngeal cancer are perennially seen in clinical practice, but immobility of the vocal folds due to cricoarytenoid joint fixation or ankylosis is seldom seen and appreciated. Hence, we present a case of bilateral cricoarytenoid joint ankylosis and discuss its etiology, pathophysiology, differential diagnoses, ancillary procedures, and management.
Ankylosis

The spinal kyphosis caused by bony ankylosis is ankylosing spondylitis and tuberculous spondylitis. There are some reports on spinal fractures through the fused vertebral body in ankylosing spondylitis, but there is no report of spinal fractures occurring in a fused vertebral body after tuberculous spondylitis. The authors report a case of spinal fracture at the apex of acute angular kyphosis after tuberculous spondylitis, which resulted in a spontaneous correction of kyphosis without neurological deficits. The fracture was stabilized by posterior interbody fusion using a mesh cage after a posterior vertebral column resection and posterolateral fusion.
Ankylosis ; Kyphosis ; Spinal Fractures ; Spine ; Spondylitis ; Spondylitis, Ankylosing

No abstract available.
Airway Management ; Ankylosis ; Humans ; Mouth ; Spondylitis, Ankylosing ; Temporomandibular Joint

OBJECTIVE: To analyze radiologic findings of cervical involvement in ankylosing spondylitis (AS) patients, determine its association with structural severity and clinical variables, and to divide radiologic findings of atlantoaxial ankylosis (AAA) in AS patients into three anatomical components. METHODS: The study includes 150 AS patients with either AAA (62 patients) or atlantoaxial subluxation (AAS, 88 patients) who underwent plain radiography of the cervical spine on flexion at our tertiary center for rheumatic diseases. The study subjects' medical records were reviewed. Lateral plain radiographs of the cervical spine were analyzed by a musculoskeletal radiologist. We compared the results of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) between AAS and AAA patients to determine if mSASSS was related to severity or duration of AS. RESULTS: The mean duration of illness in AS patients with AAA was 19.3 years, and in AAS patients 13.7 years (p<0.01). The mean total mSASSS of AS patients with AAA was 40.1, and of AAS patients 16.5 (p<0.001), and was positively associated with the development of AAA and AAS. The odds ratio (OR) of AAA development by cervical spine mSASSS change was higher (OR, 1.079) than the OR (1.049) of lumbar spine mSASSS even after adjusting for age, sex, and disease duration. CONCLUSION: Although AAA is described infrequently, we found from our data that it is another manifestation of cervical spine involvement in longstanding AS and is related to severity of AS reflected by higher cervical mSASSS.
Ankylosis* ; Atlanto-Axial Joint ; Humans ; Medical Records ; Odds Ratio ; Radiography ; Rheumatic Diseases ; Spine* ; Spondylitis, Ankylosing*

The characteristic pathological lesions in ankylosing spondylitis are vertebral body osteoporosis, ankylosis of the apophyseal joints, intervertebral disc calcification, and ligamentous ossification. Calcification of the annulus fibrosis reduces the movement and elasticity of the intervertebral disc, causing this point to be the site of least resistance when the spine is subjected to trauma. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. The ligamentous fragility and multiple fused vertebral segments cause the fractured ankylosing spondylitic spine to resemble a long-bone fracture. In ankylosing spondylitis patient who have sustained minor trauma, a complete radiological study of the entire spine and not just the symptomatic region must be performed for an accurate diagnosis, so that any fracture possible along the spine can be detected and thus prevent any medicolegal problems. The authors report 4 cases of ankylosing spondylitis including 2 cases with severe neurological abnormalities that had occurred after minor trauma.
Ankylosis ; Diagnosis ; Elasticity ; Fibrosis ; Humans ; Intervertebral Disc ; Joints ; Ligaments ; Osteoporosis ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*

The conversion of the ankylosed hip to a total hip arthroplasty may be indicated if a fused hip causes low back pain, pain in the ispilateral knee, or a fibrous ankylosis is painful. Fifteen hips converted to total hip arthroplasty between Aug., 1982 and Jul., 1988 have been reviewed one to seven years after operation and the results are as follows:1. Among the 15 hips, 8 cases confirmed as fibrous ankylosis and 7 cases confirmed as bony ankylosis. 2. The causes of ankylosis is as follow tuberculous arthritis(4 cases), secondary osteoarthritis due to pyogenic hip(4 cases), rheumatoid arthritis(4 cases), post-traumatic arthritis secondary to central fracture-dislocation of hip(2 cases), and ankylosing spondylitis(1 cases). 3. The duration of immobility of the involved hip ranged from two to twenty-five years. 4. In the 14 patients, three complained of low back pain, five of ipsilateral knee pain and six of ipsilateral hip pain. 5. The lower back pain due to malposition was relieved in all cases except ankylosing spondylitis, and the pain in ipsilateral knee was also relived in all cases after hip arthroplasty. 6. The average Harris score of the fifteen hips before arthroplasty and after was 50.1 and 88.1.
Ankylosis ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Hip ; Humans ; Knee ; Low Back Pain ; Osteoarthritis ; Spondylitis, Ankylosing

Total hip arthroplasty(THA) is applied to various hip diseases, and the results are different according to the disease entities. We have made the functional evaluation of three groups of the patients who had undergone THA in Seoul National University Hospital from 1981 to 1990: the first group-fused hips (28 hips of 27 patients), the second group partially ankylotic hips whose total range of motion were less than 60°(46 hips of 46 patients), and the third group-hips of ankylosing spondylitis (22 hips of 14 patients). The results were summerized as follows: No statistically significant difference was seen in the postoperative average Harris hip score between three groups. In the postoperative average range of motion, statistically significant difference was seen only between the first and second groups. Therefore, similar clinical results can be obtained from the THA in the fused hips to those of the partially ankylotic hips such as tuberculous or septic hip sequelae.
Ankylosis ; Arthroplasty, Replacement, Hip ; Hip ; Humans ; Range of Motion, Articular ; Seoul ; Spondylitis, Ankylosing

Ankylosing spondylitis is a chronic inflammatory disease of unknown etiology that affects spine, sacroiliac joint, and the large joints of the extremities, and lead to fibrous or bony ankylosis and deformity. The rigid ankylosed spine of ankylosing spondylitis is prone to fracture by minimal trauma, and the resulting fractures likely to be unstable and damage to spinal cord or cauda equina. The authors report a case of paraplegia in ankylosing spondylitis after open reduction of the femoral trohanteric fracture.
Ankylosis ; Cauda Equina ; Congenital Abnormalities ; Extremities ; Femur ; Joints ; Paraplegia ; Sacroiliac Joint ; Spinal Cord ; Spine ; Spondylitis, Ankylosing

ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.]]>
Adult ; Ankylosis ; Arthroplasty ; Follow-Up Studies ; Head ; Humans ; Maxillary Artery ; Mouth ; Spondylitis, Ankylosing ; Temporomandibular Joint

Ankylosing spondylitis (AS) is a chronic autoimmune disease mainly involving the axial skeleton. The pathology of the disease is usually found at the sacroiliac joint, and half of the patients experience cervical spine invasion, but eventually, the whole spine is affected. The involvement of the temporomandibular joint (TMJ) in AS has not been investigated very well. A review of the literature revealed that there are only a few studies of TMJ involvement in AS that combined clinical and radiographic examinations. These studies show widely different results, ranging between 4% and 32%. We experienced Bilateral osseous ankylosis of the jaw treated by total alloplastic joint replacement in AS, and offer a case report.]]>
Ankylosis ; Autoimmune Diseases ; Humans ; Jaw ; Joints ; Sacroiliac Joint ; Skeleton ; Spine ; Spondylitis, Ankylosing ; Temporomandibular Joint