Hoarsness in child : a missed diagnosis

Salman, Amiruddin and Hen, L.R. (2019) Hoarsness in child : a missed diagnosis. In: MSO-HNS International Conference 2019, 20-22 Jun 2019, Kuala Lumpur.

	Image FH03-FP-19-29896.png Restricted to Registered users only Download (769kB)
	Text FH03-FP-19-29648.pdf Restricted to Registered users only Download (192kB)
	Text FH03-FP-19-29647.pdf Restricted to Registered users only Download (187kB)

Abstract

Background: Hoarseness is not uncommon in children. It is described as a change of quality of voice. Most often it is due to self-limiting or non life threatening causes like viral upper respiratory infection or voice abuse. Foreign body in the airway can also solely presents with hoarseness of voice which later might potentially causing catastrophic event to the patient. We present a case of foreign body that impinged on the vocal cord which was missed initially. Reports: 11months old girl, with no known medical illness, had 1 choking episode followed by vomiting after taking rice. She presented to emergency department the same day as mother noticed patient started to have hoarseness of voice whenever she cried. No cyanotic episode or shortness of breath. Lungs was clear with no rhonchi. X ray was normal. She was treated for viral croup and discharged after 5 days of admission. Upon discharge, hoarseness was better but still persist. Patient presented again to hospital the next day with severe respiratory distress and stridor. Multiple nebulisation were given, however distress persist. Patient was subsequently planned for intubation. Upon intubation, emergency physician noticed there was a foreign body impinged on the vocal cord. Emergency operation was done with tracheostomy first for securing of airway, followed by direct laryngoscopy with foreign body removal. Intravenous dexamethasone was given for 1 day. Patient’s tracheostomy was removed 2 days later after repeated flexible nasopharyngolaryngoscopic examination (FNPLS) with normal laryngeal findings. Patient was discharge well 2 days later. Conclusions: Diagnosing laryngeal foreign body in infants can be challenging as they can’t complaint about it. Furthermore, the symptoms can sometimes be unclear. Doctors must always alert of such possibility to minimize the potential lethal complications it caused.

Actions (login required)

View Item