Rheumatoid arthritis of the cricoarytenoid joint: is early surgery superior to medical management in survival and decannulation after tracheostomy? A systematic review.

OBJECTIVE

As rheumatoid arthritis of the cricoarytenoid joint can be life-threatening, this study aimed to provide a comparison of survival and decannulation after tracheostomy for those with this condition.

METHODS

Following Preferred Reporting Items for Systematic Review and Meta-Analyses ('PRISMA') guidelines, PubMed, Web of Science, Scopus, Embase and MEDLINE library databases were queried to find all reported cases of rheumatoid arthritis of the cricoarytenoid joint.

RESULTS

A total of 55 articles with 82 patients were included in the analysis. The mean age at diagnosis was 60.1 ± 11.2 years. In cases of bilateral involvement, 71.2 per cent of patients required a tracheostomy. For those who had bilateral cricoarytenoid joint involvement and a tracheostomy, there was a significant relationship between having a primary laryngeal surgery, with or without medical management, and overall survival with ultimate decannulation compared with those with just medical management (p = 0.0022).

CONCLUSION

Tracheostomy is often necessary for acute symptom management of rheumatoid arthritis of the cricoarytenoid joint, and laryngeal surgery may be offered to facilitate ultimate decannulation.