Vocal cords paralysis
A patient of carcinoma larynx with stridor presents in casualty, immediate management is: (LQ)
|C||High dose steroid|
|D||Intubate, give bronchodilator and wait for 12 hours, if no response, proceed to tracheostomy|
Carcinoma larynx presenting with stridor means it is subglottic laryngeal carcinoma .Ideally in such cases emergency laryngectomy should be performed.
"In the case of a large subglottic tumour presenting with respiratory obstruction a case could be made for doing an emergency laryngec¬tomy."
But it is not given in the options:
• Intubation can not be done as growth is seen in subglottic area therefore tube can not be put.
• Planned tracheostomy can not be done as patient is suffering from stridor, which is an emergency. Therefore we will have to do emergency tracheostomy. With the precaution that the area of cancer should be removed within 72 hours.