A 44-year-old man complained of intermittent hoarseness of two years' duration with increased severity and persistence during the two months prior to seeking medical attention. Other than a 45 pack per year history of cigarette smoking, he had no exposure to toxic inhalants or excessive voice use. A previous tracheostomy had been performed at age 18 to aid in six weeks of iron lung therapy for C3 to C4 level bulbar polio; complete resolution had occurred.
The patient was an endomorphic individual with mild inspiratory and expiratory stridor at rest. Cervical adenopathy was absent. Indirect laryngoscopy disclosed a 1 × 1-cm mucosally covered, bluish-red polypoid lesion of the right posterior false vocal cord overhanging a normally functioning true vocal cord. A biopsy specimen of the lesion under direct laryngoscopy demonstrated a freely bleeding sessile mass with an ulcerated inferior-medial aspect. Tracheostomy was required to assure adequate postoperative ventilation.
FECHNER RE. Resident's Page. Arch Otolaryngol. 1976;102(7):442–445. doi:10.1001/archotol.1976.00780120090017
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