Nov 2011|Vol 8|Iss 11

   
 
Case
 
   
A case of Vocal cord swelling
 

 

Dr.Sivakumaran is a young enthusiastic clinician, dedicated himself in research oriented, documented, evidence based case studies. His articles, case studies had been published in the leading journals. Here he presents a case of swelling in the vocal cord.

 
 
 

       A 72 year-old male suffering from cough since two years, then he was suffered from loss of voice since one year. He had pain in the throat since one year.

History of presenting illness

Nonproductive cough < while lying down, > at night, severe burning in the throat since one year unable to swallow since three months, dryness of mouth and bitter taste in the mouth. The patient’s care givers emphasized that the patient had sleeplessness almost every night.

Past history

A known case of diabetes and hypertension. The patient also suffered from hemorrhoids and was under allopathic medication for these conditions.

Family History

His father expired due to renal failure as a complication of his diabetic state. His mother died from Ca cervix.

Personal history

The patient is a tobacco chewer (Ganesh pogaillai) and panparak. Nonsmoker, nonalcoholic.

Mental generals

Restlessness, anxious, extreme worry about his illness.

Physical general

He preferred a liquid diet due to his difficulty in swallowing solids. Thirst was increased. Had bitter taste in the tongue. Desire for hot drinks. Dry skin with itching all over. Frequent urination. Sleeplessness was severe. Thermally, chilly patient.

Physical examination

On examination, he had difficulty in protruding his tongue due to severe pain. Tongue was coated white. The patient came to the clinic with the help of attenders, he was weak and tired. He had a dark complexion. The patient was anemic, not jaundiced.

Systemic examinations

All systems were normal on examination.

Investigations

Haemoglobin – 12.8 mg%, blood sugar – 154 mg/dl, blood urea – 28 mg/dl, serum creatinine – 1.3 mg/dl, HBsAG – negative, HCV Ab – Nonreactive, bleeding time – 2 minutes 30 seconds, clotting time – 5 minutes 30 seconds, blood group – AB positive.
Biopsy done on December 9, 2009 showed well differentiated keratinized squamous cell carcinoma of the left vocal cord. (Refer Plate before )
Echocardiogram and routine urine exam were normal.

 

First prescription                                     25-1-2010
R/x
Carcinosin 1M a single dose.

Follow up 1                                               20-2-2011

During his second follow up, after careful repertorization, Arsenicum album 0/1 in 120 ml of water was prescribed.

Follow up 2                                               21-3-2011

The patient reported feeling better, cough had reduced, voice production and speech had improved. Arsenicum album 0/2 in 120 ml as aqueous solution was prescribed in the same manner as described above.

Follow up 3                                              21-4-2011

The patient reported no cough and his speech was clear now. The same medication was repeated.

Follow up 4                                             10-5-2011

The patient reported no cough and his speech was clear now. The same medication was repeated in 0/3 potency.

Follow up 5                                             17-6-2011

The patient was asked to undergo MRI - neck. The report showed no evidence of vocal cord growth on the left, no evidence of cervical lymphadenopathy. Supraglottic and infraglottic airways were normal. (Refer Plate after). Regular follow-ups were continued with Arsenicum album 0/6.