A patient with a hoarse voice (2008: 6a)

Excerpt

An 83-year-old man presented with a history of hoarseness, neck swelling and shortness of breath. There was no history of dysphagia, voice strain or neck pain. Physical examination revealed a slight smooth fullness of the right neck, but no nodularity to suggest cervical lymphadenopathy. Fibre-optic endoscopy revealed right vocal cord immobility. No intrinsic vocal cord lesion was identified. This was consistent with right recurrent laryngeal nerve palsy. CT was performed through the neck and chest, and Figs. 1, 2 and 3 are presented.

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