title: Mislaid dentures: a cause for unusual presentation of bilateral vocal cord palsy.
abstract: An 81-year-old man was referred urgently to the head and neck clinic with symptoms of worsening dysphagia, dysphonia and weight loss. He had a history of chronic lymphocytic leukaemia. On full ear, nose and throat examination, he was found to have fixed vocal cords with pooling of saliva in the bilateral pyriform fossa. Hypopharyngeal malignancy was suspected and further imaging was performed. Imaging also raised the suspicion of malignancy in the hypopharynx. Rigid endoscopic examination under general anaesthesia was carried out which revealed an impacted denture in the cricopharynx and upper oesophagus. The patient was aware of his loss of dentures 3 months ago (corresponds to the onset of his symptoms) but felt that he had mislaid them and had never mentioned this to anyone. We present a case highlighting a delay in diagnosis, a missed diagnosis on CT scan and an unusual presentation leading to bilateral vocal cord paresis.
authors.affiliation: Department of Otolaryngology and Head and Neck surgery, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Vamsidhar
authors.initials: V
authors.lastname: Vallamkondu
authors.affiliation: Department of Otolaryngology and Head and Neck surgery, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gatenby
authors.affiliation: Department of Otolaryngology and Head and Neck surgery, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shakeel
authors.affiliation: Department of Otolaryngology and Head and Neck surgery, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Akhtar
authors.initials: A
authors.lastname: Hussain
mesh_terms: D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D003778:Dentures / Q000009:adverse effects*; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology*; D004435:Eating; D004947:Esophagus / Q000473:pathology; D005547:Foreign Bodies / Q000150:complications*; D006801:Humans; D007013:Hypopharynx / Q000473:pathology*; D008297:Male; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology*; D014827:Vocal Cords / Q000473:pathology*