Pivoting larynx--an unusual clinical observation at laryngoscopy

Rigid oesophagoscopy was planned in the investigation of a young patient with dysphagia. During laryngoscopy for tracheal intubation an unusual pivoting manoeuvre was required to see the vocal cords. Although the initial diagnostic investigations were unhelpful, follow up directed at explaining the clinical observations led to an eventual diagnosis of anterior tubercles of C6, which explained the observation and accounted for the dysphagia.