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Clinical Challenge | Endoscopy

A Submucosal True Vocal Fold Mass QUIZ

Lawrence Williams, MD1; Clint Allen, MD2
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
2Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Otolaryngol Head Neck Surg. 2015;141(11):1025-1026. doi:10.1001/jamaoto.2015.2168.
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A man presented with sudden-onset, progressively worsening dysphonia, dry cough, sensation of a lump in his throat, and a progressively worsening voice; videostroboscopic examination revealed a broad-based submucosal mass in the anterior two-thirds of the right true vocal fold. What is the diagnosis?

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A and B, Clinical views of endoscopic appearance of the anterior right true vocal fold mass. A, View showing vocal folds abducted. B, View showing vocal folds adducted. C and D, Intraoperative endoscopic views. C, Submucosal mass. D, A microflap incision was performed along the lateral aspect of the lesion and a multilobulated, firm submucosal mass deep to the epithelium but superficial to the vocal ligament was resected.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Clinic Videostroboscopy

Videostroboscopy reveals little to no vibration of either true vocal fold with high- or low-pitch phonation. Slight vibration of the posterior left vocal fold is elicited with a breathy sigh.

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