Tooth and ENT Doctor

My former classmate in elementary referred his father to me for evaluation and management because of two-months history of hoarseness and nonproductive cough. He has a 30 pack-years smoking history but apparently had quit smoking a few months earlier. He denied chest pain and dysphagia. On laryngoscopy, the left vocal fold was paralyzed. No laryngeal mass noted. I requested for a computed tomography (CT) scan of the neck and chest and a 6 x 7 cm mass was noted at the left hilar area. I referred him for CT scan guided biopsy of the mass. This is the normal vocal fold movements. Unilateral vocal cord paralysis occurs secondary to dysfunction of the recurrent laryngeal or vagus nerve innervating the larynx. Patients typically present with a fairly sudden onset of a “breathy” voice because of incomplete adduction of the paralyzed vocal cord. In addition, the patient may complain of his or her “voice going away” and shortness of breath. Normally, upon speaking, both vocal cords addu...

My sister called up yesterday complaining of hoarseness. It apparently started with a sore throat and a nonproductive cough with low-grade febrile episode 7 days ago. She took some antibiotics and cough medications but no relief was noted. Clearly, she is suffering from laryngitis. Laryngitis is an irritation and swelling of the voice box and the area around it. It causes the voice to change, or you may lose your voice entirely for a short while. With or without treatment, it is expected to resolve in 7 to 14 days. It is usually caused by a virus or by bacteria. People who smoke, have allergies, or strain their voices by yelling, talking, or singing may also come down with the problem. The classic symptoms are a hoarse, low voice, and a scratchy throat. Other people may also lose their voice, develop a sore throat, come down with a fever, feel a lump in their throat, or feel very tired. As an ENT specialist, I usually advise voice rest if these symptoms have been present fo...