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A 69-year-old woman experienced new voice changes and shortness of breath. Investigations revealed severe obstructive lung disease and pachydermatous changes, suggesting potential reflux or chronic infection.

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Area of Science:

  • Pulmonology
  • Otolaryngology
  • Radiology

Background:

  • A 69-year-old woman presented with new-onset dysphonia and shortness of breath.
  • Medical history includes asthma, allergic rhinitis, and gastroesophageal reflux disease.
  • Patient is a current smoker with a 40-pack-year history and yearly lung cancer screening.

Purpose of the Study:

  • To investigate the cause of new-onset dysphonia and shortness of breath in a patient with a history of smoking and respiratory conditions.
  • To evaluate pulmonary function and laryngeal findings in the context of respiratory symptoms.

Main Methods:

  • Pulmonary function tests (PFTs) including spirometry, bronchodilator response, and diffusion capacity.
  • Review of serial low-dose computed tomography (CT) lung screening studies.
  • Flexible laryngoscopy to assess vocal cord function and laryngeal mucosa.

Main Results:

  • PFTs demonstrated severe obstructive lung disease with air trapping and reduced diffusion capacity for carbon monoxide.
  • Laryngoscopy revealed pachydermatous changes in the interarytenoid fold mucosa.
  • CT scans were reviewed as part of the diagnostic workup.

Conclusions:

  • The patient's symptoms may be related to severe obstructive lung disease.
  • Laryngeal findings suggest potential nasopharyngeal reflux or chronic infection as contributing factors.
  • Multidisciplinary evaluation is crucial for managing complex respiratory and laryngeal symptoms.