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Clinical Challenge
May 26, 2016

Voice Change, Odynophagia, and Neck Pain Following a Sneeze

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Augusta University, Augusta
  • 2Division of Otolaryngology–Head and Neck Surgery, University of California, San Diego, La Jolla

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JAMA Otolaryngol Head Neck Surg. Published online May 26, 2016. doi:10.1001/jamaoto.2016.1151

A man in his 30s presented to the emergency department with sudden voice change, odynophagia, and left-sided neck pain following a single sneeze. He experienced a popping sensation during the sneeze followed by neck stiffness 15 minutes later. He did not have associated shortness of breath, hemoptysis, or other pertinent medical history. He had no history of trauma, surgery, or intubation. On physical examination, his vital signs were stable with normal oxygen saturation on room air. His voice was rough and without stridor. Anterior neck examination revealed tenderness over the thyroid notch and left side of the laryngotracheal complex. There was no palpable crepitus. Flexible laryngoscopy was performed, which showed hematoma of the left true vocal fold and laryngeal surface of the epiglottis with normal vocal fold movement and complete glottic closure (Figure, A).

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