Woman With Voice Changes and Cough

Abstract

A 67-year-old woman with longstanding tobacco use presented to the emergency department with a persistent cough, difficulty in phonation worsening over several weeks, hoarseness, and a globus sensation. Her vital signs were normal, but she had audible stridor with an otherwise normal oropharyngeal examination. The emergency physician performed bedside transcutaneous laryngeal ultrasound of the patient’s vocal cords (Figure 1), and the otolaryngologist confirmed the diagnosis with flexible fiberoptic laryngoscopy (Figure 2 and Video E1 [available at http://www.annemergmed.com]).