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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for hoarseness of voice post a thyroid cartilage fracture

Answered by
Dr.
Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2592 Questions

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Posted on Mon, 22 Aug 2016 in Ear, Nose and Throat Problems
Question: Is it normal, after a thyroid cartilage fracture (it happened a few days ago) that I feel like my voice is getting worse? I had no problem right after the accident, but now it feels like my voice is getting lower, a little less "clear", and I'm unable to speak in a higher pitch. For the time being the doctor thinks that it wouldn't be wise to proceed surgically to realign the fracture, as it could do more harm than good. The doctor prescribed the use of cortisone pills and a neck collar, to keep the fracture as still as possible while waiting for my check-up appointment next week. Could it be that the constant use of the neck collar - I remove it only to eat and sleep - is affecting my voice? I'm really worried this could be permanent.
doctor
Answered by Dr. Sumit Bhatti 1 hour later
Brief Answer:
VL'Scopy. CT+MRI Neck. Avoid the collar.

Detailed Answer:
Hi,

Thank you for your query.

1. Direct visualisation of the larynx by a Videolaryngoscopy (VL'Scopy) should be done to rule out any swelling, haematoma or vocal cord dysfunction.

2. Since the larynx moves while swallowing, eating, speaking, avoid using the neck collar.

3. Since there is no breathlessness, treatment should be conservative with anti inflammatory medication including steroids.

4. Undisplaced fractures should be left alone.as these changes occurred a few days after the incident, these changes should be temporary.

5. Upload images of the larynx and scan images for ain accurate assessment and further treatment options.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 16 minutes later
Thank you very very much for your quick and kind reply. The doctor used the vl'scopy. He also had me pronounce long vocalic sounds while observing, and I think he didn't see anything wrong. Unfortunately I am not in possess of the scan images. The diagnosis report I was given reads: "To the touch, it can be detected a minor asymmetry in the thyroid cartilage; dysphonia manifests when rotating the head. Fibrolaryngoscopy: there are no larynx edemas, breathing space is good. The only dubious element is the asymetry in the thyroid cartilage, which is modified during respiration." After the CAT exam, the doctor wrote: "Thyroid cartilage fracture that does not involve any functional limitations. Therefore, at this time there is no need for surgical stabilization".
doctor
Answered by Dr. Sumit Bhatti 22 hours later
Brief Answer:
Details as described below :

Detailed Answer:
Hi,

Thank you for writing back.

1. Since the VL'Scopy and Scan findings do not reveal any major problem, there is no cause for worry.

2. Request medication (including steroids) to settle the local inflammation.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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