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September 1973

The Resident's Page

Author Affiliations

The Methodist Hospital, Houston 77025

Arch Otolaryngol. 1973;98(3):212-214. doi:10.1001/archotol.1973.00780020220018


Frank I. Marlowe, MD, Philadelphia  The patient is a 32-year-old Negro man who presented with a complaint of "sore throat." Past history included a hospitalization some 18 months previously for arthralgia involving the low back, shoulders, knees, and elbows. An extensive work-up at that time culminated in biopsy of a small nodule on the right elbow (Fig 1). Current physical examination was within normal limits except for a paresis of the soft palate, pharyngeal wall, and vocal cord, all on the left. There was some pooling of saliva in the left pyriform sinus and a small midline cystic lesion in the nasopharynx. The patient's voice quality was somewhat nasal. The patient was hospitalized and an extensive work-up for pathological findings about the jugular foramen to explain the paresis of the ninth and tenth cranial nerves was nonrewarding. During the period of the patient's hospitalization, a large,

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