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What Causes Intermittent Hoarseness In The Voice And Weight Loss?
Question: 1) There is intermittent hoarseness of voice and few kgs weight loss. All reports CBC, Sugar, Lipid profile, Kidney, Liver, Vit D, Thyroid are normal. Plain CT scan is normal. sONOGRA
and upper GI.
2) Please specify which hygienic pathological labs in XXXXXXX perform NON INVASIVE diagnostic tests for larynx, pharynx and oesophagus
3) Also please do advise consulting ENT specialists who are well known in XXXXXXX who can be consulted on
DETAILED HISTORY AND QUESTION
1) Basic: Age 65 years ; S: Male Problem: Intermittent hoarsness of voice.
2) Good health record. No major hereditary history except allergies of dust mites..
3) Unintended Weight loss since a year of about 7-8kg.
Tests done & results
Cholesterol, Glucose, B12, Vit D, Thyroid, Electrolyte, liver & kidney normal. X ray normal,
CBC – Lymphocytes 54%. Monocytes,neutrophils, eosonophils,basophils within limits. Haemoglobin 11.8 WBC count higher on peripheral smear, Absolute lymphocytes – 6500 RBC morphology : normocytic normochromic cells seen.
ESR – 107 ( when test was done some cough was there that is now gone)
Multislice CT scan ( WITHOUT IV Contrast) = Mild bronchial & bronchiolar prominence seen in bilateral lung parenchyma with patchy areas of air trappings. Few peribronchial nodules are seen scattered in bilateral lung parenchyma. Nasopharynx, oropharynx, & hypopharynx are normal with normal pharyngeal mucosal,parapharyngeal,retropharyngeal, prevertebral, masticulator parolid spaces. Hypopharyngeal structures including median –lateral glosso epiglottic folds, valleculae and pyriform sinuses are normal. The laryngeal structures including epiglottis,ary epiglottic folds, true and false vocal cords are normal. Thyroid and cricold cartilage and hyois=d bone are normal. No evidence of lymphadenopathy is seen. No cystic / solid mass is seen in neck. No other significant pleuropulmonary pathology is seen. No significant mediastinal or hilar lymphadenopathy is seen. Liver is normal size, shape,position and contour, gall bladder is normal. No interhepatic biliary dilation.
Abdominal & Pelvic sonography normal
Questions:
1) Does video larayngoscope or video Videostroboscopy. ... offer any different info to plain CT scan and is it required?
2) If we decide to do it, Please specify which hygienic pathological labs in XXXXXXX perform these NON INVASIVE diagnostic tests for larynx, pharynx and oesophagus
3) Also please do advise Consulting ENT specialists who are well known in XXXXXXX who are not performing operations but are purely for guidance & less commercial .
Thanks XXXXXXX
and upper GI.
2) Please specify which hygienic pathological labs in XXXXXXX perform NON INVASIVE diagnostic tests for larynx, pharynx and oesophagus
3) Also please do advise consulting ENT specialists who are well known in XXXXXXX who can be consulted on
DETAILED HISTORY AND QUESTION
1) Basic: Age 65 years ; S: Male Problem: Intermittent hoarsness of voice.
2) Good health record. No major hereditary history except allergies of dust mites..
3) Unintended Weight loss since a year of about 7-8kg.
Tests done & results
Cholesterol, Glucose, B12, Vit D, Thyroid, Electrolyte, liver & kidney normal. X ray normal,
CBC – Lymphocytes 54%. Monocytes,neutrophils, eosonophils,basophils within limits. Haemoglobin 11.8 WBC count higher on peripheral smear, Absolute lymphocytes – 6500 RBC morphology : normocytic normochromic cells seen.
ESR – 107 ( when test was done some cough was there that is now gone)
Multislice CT scan ( WITHOUT IV Contrast) = Mild bronchial & bronchiolar prominence seen in bilateral lung parenchyma with patchy areas of air trappings. Few peribronchial nodules are seen scattered in bilateral lung parenchyma. Nasopharynx, oropharynx, & hypopharynx are normal with normal pharyngeal mucosal,parapharyngeal,retropharyngeal, prevertebral, masticulator parolid spaces. Hypopharyngeal structures including median –lateral glosso epiglottic folds, valleculae and pyriform sinuses are normal. The laryngeal structures including epiglottis,ary epiglottic folds, true and false vocal cords are normal. Thyroid and cricold cartilage and hyois=d bone are normal. No evidence of lymphadenopathy is seen. No cystic / solid mass is seen in neck. No other significant pleuropulmonary pathology is seen. No significant mediastinal or hilar lymphadenopathy is seen. Liver is normal size, shape,position and contour, gall bladder is normal. No interhepatic biliary dilation.
Abdominal & Pelvic sonography normal
Questions:
1) Does video larayngoscope or video Videostroboscopy. ... offer any different info to plain CT scan and is it required?
2) If we decide to do it, Please specify which hygienic pathological labs in XXXXXXX perform these NON INVASIVE diagnostic tests for larynx, pharynx and oesophagus
3) Also please do advise Consulting ENT specialists who are well known in XXXXXXX who are not performing operations but are purely for guidance & less commercial .
Thanks XXXXXXX
Brief Answer:
Yes, these procedures will help.
Detailed Answer:
Hi,
Thank you for your query.
1. Yes, Videolaryngoscopy or preferably Videostroboscopy offers additional information on function. The vocal cords vibrate at frequencies up to 100 times per second and are not visible normally. CT/ MRI imaging provides information on structure (form) and not function. Hence you should get these simple investigations done. Any major hospital will ensure hygienic procedures.
2. The examination of the pharynx and larynx will be noninvasive. Esophageal and windpipe examination is always invasive.These can be planned later if required.
3. If you can let me know the area in XXXXXXX where you want to consult an ENT Specialist, I can recommend a few specialists. You can also drive down to XXXXXXX for the tests. For guidance and to avid commercial coercion, it is advisable to get multiple opinions before starting any treatment.
4. With your symptoms and current test results, it is important to rule out tuberculosis.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Yes, these procedures will help.
Detailed Answer:
Hi,
Thank you for your query.
1. Yes, Videolaryngoscopy or preferably Videostroboscopy offers additional information on function. The vocal cords vibrate at frequencies up to 100 times per second and are not visible normally. CT/ MRI imaging provides information on structure (form) and not function. Hence you should get these simple investigations done. Any major hospital will ensure hygienic procedures.
2. The examination of the pharynx and larynx will be noninvasive. Esophageal and windpipe examination is always invasive.These can be planned later if required.
3. If you can let me know the area in XXXXXXX where you want to consult an ENT Specialist, I can recommend a few specialists. You can also drive down to XXXXXXX for the tests. For guidance and to avid commercial coercion, it is advisable to get multiple opinions before starting any treatment.
4. With your symptoms and current test results, it is important to rule out tuberculosis.
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. Veerisetty Shyamkumar
What is the specific test for Tuberculosis that is not visible via CBC, X ray or CT scan? Kindly specify. As for video laryngoscopy or stroboscopy what are the possibilities that arise? Please list positive & negative. Reason I ask is that we do not wish to do treatment that is surgical or invasive. We are only open to oral medication in either allopathy, Ayurveda or homeopathy... so please specify whether it is even worthwhile doing it in the first place?
We are based in Andheri West. We would appreciate an ENT specialist who is only consulting and can suggest oral medication
We are based in Andheri West. We would appreciate an ENT specialist who is only consulting and can suggest oral medication
Brief Answer:
Details as discussed below:
Detailed Answer:
Hi,
Thank you for writing back.
1. A Tuberculin (Mantoux) Test and a TB Gold (Quantiferon) test can be done.
2. There are many findings from normal to abnormal that can be detected on laryngoscopy. The description of each and every possibility is beyond the scope of this answer. It is better to get this examination done and then discuss the findings. You can upload images or a video for discussion.
3. You may consult Dr. XXXXXXX Shenai or Dr XXXXXXX Bhargava.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Details as discussed below:
Detailed Answer:
Hi,
Thank you for writing back.
1. A Tuberculin (Mantoux) Test and a TB Gold (Quantiferon) test can be done.
2. There are many findings from normal to abnormal that can be detected on laryngoscopy. The description of each and every possibility is beyond the scope of this answer. It is better to get this examination done and then discuss the findings. You can upload images or a video for discussion.
3. You may consult Dr. XXXXXXX Shenai or Dr XXXXXXX Bhargava.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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