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March 1975

Resident's Page

Author Affiliations

The Methodist Hospital, Houston, TX 77025

Arch Otolaryngol. 1975;101(3):202-204. doi:10.1001/archotol.1975.00780320060014


William W. Gordon, MD, Houston  A 67-year-old man was admitted to the medical service for hemoptysis, cough, and dyspnea on exertion of several days' duration. The patient had smoked several packs of cigarettes a day for 50 years. Despite a negative history of heart disease, it was felt the patient had congestive heart failure. Treatment with oxygen, diuretics, and digitalis only produced minimal improvement. After four days in the hospital an otolaryngology consult was obtained because the patient reported his voice was weaker and of a different character than it had been several weeks before. Routine ear, nose, and throat examination revealed bilateral vocal cord paralysis with the cords in a paramedian position. No discrete lesions were seen. There were no palpable nodes in the neck. The patient was taken to surgery for direct laryngoscopy and bronchoscopy. A lesion was biopsied (Fig 1). What is