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Year: 2012  Vol. 16   Num. Suppl. 1  - May
DOI: 10.7162/S1809-977720120S1PO-002
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11º CONGRESSO DA FUNDAÇÃO OTORRINOLARINGOLOGIA - Poster Otorhinolaryngology
Texto Text in Portuguese
PARADOXICAL ADDICTION OF VOCAL FOLDS OF DIFFICULT DIAGNOSIS
ADÇÃO PARADOXAL DE PREGAS VOCAIS DE DIFÍCIL DIAGNÓSTICO
Author(s):
Fernanda Alves Monteiro, Vinicius Ribas Fonseca, Marcelo Charles Pereira, Yara Alves de Moraes do Amaral, Eduardo Lopes El Sarraf, Eliza Mendes de Araújo
Abstract:

The objective is to tell a case of paradoxical addiction of the laryngeal folds of difficult diagnosis. JRSM, feminine, 46 years. In 2008 after patient gripal picture initiated with dyspnea of strong associated intensity the stridor and respiratory effort that initially do not had a triggering factor. In this period presented normal videolaryngoscopy. In 2009 it started to associate the crises to the contact with smell of substantiate irritating. In 2011 it initiated inquiry with otolaryngologist and pneumologist, still with crises, carried through spirometry demonstrating obstructive riot light extra-thoracic without reply to the bronchodilator. Computerized tomography of cervical, ray-x of normal thorax and audiometry. New laryngoscopy evidenced breathing collapsing of the structures of the larynx, provoking noise and breathing dyspnea, suggesting laryngomalacy. Absence signals of tracheomalacy in the fibrobroncoscopy. As co-morbid, presented hypothyroidism and depression in treatment and hiatal hernia in use of pantoprazol 80mg. It denied tobaccos. To the otolaryngologic examination presented left light hypertrophy of cornet. Physical examination general inters crises inside of normality. As diagnostic differentials had been suggested: Factorial asthma, syndrome of Munchausem and dyskinesia larynx, remaining with final diagnosis dyskinesia larynx. In specific phonoaudiologic with improvement of the picture. The main distinguishing diagnosis of the dyskinesia larynx is the asthmatic crisis, however diagnostic of psychogenic order always must be remembered, therefore they possess important paper in this scene. The laryngeal dyskinesia for being an entity of difficult recognition in the initial handling can be responsible for a very bigger incidence that usually described, and stories as this is excellent to demonstrate clinical manifestations and to characterize the disease for a correct therapeutical boarding.

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