Rheumatoid arthritis is a destructive autoimmune disease that affects 3% of the adult population. It is characterized by the formation of both articular and extra-articular lesions with predilection for small joints. There are ubiquitous reports on the head and neck manifestations of RA with emphasis on the larynx. The laryngeal presenting features of this systemic disease may mimic a plethora of medical conditions, inflammatory and neoplastic. The main phonatory and respiratory symptoms are often subtle and misleading. This paper represents a literature review of the laryngeal manifestations of RA with emphasis on the clinical symptoms, laryngeal findings, diagnosis, and treatment. An early diagnosis of laryngeal involvement may prevent drastic complications. 1. Introduction Rheumatoid arthritis is a common autoimmune disease that affects 3% of the adult population and up to 35 per 100,000 of the pediatric population [1, 2]. It is a destructive systemic disease that affects all joints in the body. The course of the disease is characterized by remissions and exacerbations, with chronicity often leading to disability. It is characterized by the formation of both articular and extra-articular lesions with predilection for small joints [3, 4]. Pressure areas are affected the most, with inflammation of the synovial membrane often leading to bony destruction and joint deformities. Extra-articular nodules may also be present in various organs of the body in up to 20% of the cases [3–7]. The head and neck manifestations of RA may be the sole presenting feature of this systemic disease mimicking a plethora of medical conditions, inflammatory and neoplastic. The otolaryngologic signs and symptoms of RA are protean and ill defined, with joint involvement being the most significant. These include the temporomandibular joint, the cricoarytenoid joint, and the cricothyroid joint. 2. Method A search of the literature via MEDLINE (PubMed) using rheumatoid arthritis and larynx as key words was performed by the authors. Relevant articles were reviewed, and information was retrieved and stratified based on epidemiology, clinical symptoms, laryngeal findings, diagnosis, and treatment. 2.1. Epidemiology Laryngeal involvement in patients with RA is invariably underdiagnosed early in the course of the disease in view of the subtle clinical findings. A high index of suspicion is often needed to recognize laryngeal involvement especially in the presence of confounding factors such as laryngopharyngeal reflux disease and allergy. The prevalence of the laryngeal manifestations
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