ENT patient

[heykki]

Wanna try to solve this one?

The patient is sixteen year old female. She does not smoke and hasn not been in an injury. No externally seen deformations.

Occasionally, she feels like she can't breath, like she had something, like a stone in her throat (where men have Adam's apple). This comes roughly once or twice a week, sometimes more and occurs usually between 6 PM and 1 AM. Sitting and breathing fresh air helps a little bit. She has found that she hears clicking sound when she is bending her head to look upwards. She has been tested for asthma, but does not have it. She also visited an ENT at public hospital who said after 10 minutes of investigation that it is normal.

What could be wrong?

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[CTashby]

How long has this been going on for? Has she ever had anything like this before? Any pain associated with this problem? Has she swallowed any chicken bones lately? physical exam?

 

[toofache32]

And what did you see on fiber-optic laryngoscopy? You haven't given all the info here.

 

[Spiff]

GERD? Occupational airborne irritant exposures? Frequent sinusitis/PND?

Any prior history of psychiatric illness? Is she a singer by chance... maybe a little high strung on the personality side?

Before we get to the money with laryngoscopy/strobe does she have any adventitious upper airway sounds on exam?

 

[heykki]

No psychiatric illnesses and she is not a singer either. It has been for six years. There is no pain associated and it is not caused by a chicken bone. The doctor did not do fiber-optic laryngoscopy. All the examinations included: Asthma and airbone irritant exposure. The doctor did not hear any adventitious upper airway sounds.

Sorry for leaving out some info. I had not examined her but I have seen the results of her brief examination by the ENT doc.

This goes to offtopic but I have to say that the public health system in Finland= (just because they do not examine well enough in order to save money)

 

[OMFSCardsFan]

No psychiatric illnesses and she is not a singer either. It has been for six years. There is no pain associated and it is not caused by a chicken bone. The doctor did not do fiber-optic laryngoscopy. All the examinations included: Asthma and airbone irritant exposure. The doctor did not hear any adventitious upper airway sounds.

Sorry for leaving out some info. I had not examined her but I have seen the results of her brief examination by the ENT doc.

This goes to offtopic but I have to say that the public health system in Finland= (just because they do not examine well enough in order to save money)

Is there ever going to be any conclusion to this?

 

[unregistered]

.

 

[unregistered]

Is there ever going to be any conclusion to this?

NO. Some loser wants a free diagnosis on the internet. Pretty obvious she has reflux.

 

[neutropeniaboy]

NO. Some loser wants a free diagnosis on the internet. Pretty obvious she has reflux.

Yeah. I used to think like that until I did an endoscopy on two patients almost exactly like that: 1 had a fungating epiglottic mass and the other had a condroma of the subglottis.

 

[TheThroat]

Yeah. I used to think like that until I did an endoscopy on two patients almost exactly like that: 1 had a fungating epiglottic mass and the other had a condroma of the subglottis.

The thing is that all these patients need a look at the ol' lar-nyx, whether with a mirror or with a scope.

 

[neutropeniaboy]

...the ol' lar-nyx, whether...

No. It's "learn-ix."