A 16-yr old girl with chronic pulmonary hypertension presents with hoarseness of voice for 4 months' duration. Above is the view of her larynx through a flexible naso-pharyngo-laryngoscope and an accompanying chest X-ray.
Q1: Describe the abnormalities seen.
Q2: What is the diagnosis based on the laryngeal appearance?
Q3: From the chest X-ray, what do you think is the cause for this pathology?
Posts
108 comments:
left vocal cord paralysis secondary to cardiomegaly - impingement of the enlarged left atrium to the LRLN. ortner's syndrome (as in horse)
That would be right. However, in an exam VIVA you would need to describe the appearance (Q1) that leads to your diagnosis.
A few follow up questions would be:
1. How would you determine if this is an abductor or adductor palsy?
2. Given your hypothesis of Ortner's syndrome, what sort of paralysis would you expect - abductor or adductor? Why?
abductor
To diff between abduction and adduction palsy.
Can you have the patient say “HEE” (deep inspiration), “HEE” (deep inspiration), “HEE with the flexible laryngoscope in?
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