Answers:
A patient presents to your clinic with complaints of a change in her voice over the past three months. She appears to have a weak voice, which gets worse with use. She does not smoke, denies hemoptysis, dyspnea or cough. She states that she recently underwent surgery and points to a scar on her neck. When performing laryngoscopy what would you expect to see?
A) A vocal cord nodule
B) A vocal cord polyp
C) A single vocal cord in the intermediate position
D) A single vocal cord in the cadaveric position
E) A single vocal cord in the paramedian position
With regards to recurrent laryngeal nerve paralysis, which is more commonly injured. LRLN or RRLN? Why?
LRLN is more commonly injured due to its longer course.
MC Question:
Pt presents with dysphonia and a hx of aspiration pneumonia. On laryngoscopy the left vocal cord is found to remain lateral even during phonation. Where is the most likely area for the lesions causing this paralysis?
A) At the site of the false vocal cord
B) At the site of the true vocal cord
C) Below the origin of the superior laryngeal nerve
D) Above the origin of the superior laryngeal nerve
Free Response Questions:
What are two procedures used to medialize paralyzed vocal folds?
What are two procedures used to medialize paralyzed vocal folds?
Quick Facts:
Bilateral Recurrent Laryngeal Nerve Paralysis
-often recent hx of thyroid surgery (usually total)
-presentation is often in the ED w/ stridor as minimal swelling can occlude airway.
-tracheotomy is often only viable option emergently.
-some nerve recovery is expected in 50% of patients.
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