Question

Mrs. Hepple, age 65, underwent surgery to remove a portion of her esophagus that was cancerous. After surgery, her voice was breathy, and she choked every time she drank water. In addition, the food she swallowed came back up. She was sent to an otolaryngologist, who examined her vocal folds and noted that the left vocal fold was not moving during voicing. She was referred to a speech-language pathologist, who used rigid video endoscopy with a strobe light to further evaluate her voice. Mrs. Hepple's vocal folds did not come together come together completely when vibrating. The speech-language pathologist was concerned about Mrs. Hepple's difficulties with swallowing and suggested a modified barium swallow study. During this test, the speech-language pathologist noted that liquids entered Mrs. Hepple's trachea during the pharyngeal phase of swallowing. Subsequently, she chocked and coughed to clear the liquid from her airway. 2. What type of disorder(s) is Mrs. Hepple potentially demonstrating?

Answer 1

Mrs. Heple suffer from recurrent laryngeal nerve injury as this is the important nerve of larynx . It innervates the cricopharyngeal muscle that is important for swallowing. Patient with this disorder usually present with hoarseness, aspiration which are also found in this case. Furthur the patient has underwent oesophageal surgery that lead to this complication.