Complete Bilateral Ossification of the Arytenoid Cartilages With Minimal Involvement of the Laryngeal Skeleton: A Unique Anatomical Variation

The arytenoid cartilages are distinguished by their mobility and unique mixed composition of hyaline and elastic cartilage. Though laryngeal cartilage ossification is not rare, and its pattern is well-studied, sole complete and bilateral arytenoid cartilage ossification is an aberration. An 84-year-old woman, with no history of voice or breathing issues, was brought to the emergency department for a head-and-neck trauma following a fall. CT scans revealed a subdural hematoma and, incidentally, a bilateral ossification of the arytenoid cartilages, sparing the vocal processes but involving complete ossification of the hyaline part and the tip. The cricoid cartilage was non-ossified, and the thyroid depicted minor ossification. We present a unique, previously undocumented case of both arytenoid cartilages simultaneously ossified in a patient without laryngeal pathology. In previous studies on laryngeal cartilage ossification during aging, no cases have demonstrated either bilateral complete ossification of the arytenoid cartilages or arytenoid ossification occurring before that of the thyroid and cricoid cartilages. Ossification is an age-related process; our case's ossification pattern does not align with the expected final stage. The involvement of the arytenoid tip is also an exceptional observation. The unique anatomical variation in the laryngeal ossification pattern underlines that arytenoid cartilage ossification may be complete and bilateral and precede that of the thyroid or cricoid cartilage. It could be the only notable feature on a neck scan of a patient with no history of laryngeal disorders.