Внутренние болезни
TRACHEAL DIVERTICULUM AS A RARE CAUSE OF UNILATERAL PARESIS OF THE VOCAL FOLD: MULTIDISCIPLINARY PERSONALIZED APPROACH TO DIAGNOSIS AND TREATMENT
M. Y. Savina1, D. A. Gusarova1, T. V. Bolshova1,2, O.V. Medvedeva2
1. Limited liability company SM-Regionmed, Ryazan, Russia
2. Ryazan State Medical University of the Ministry of Health of Russia, Ryazan, Russia
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Summary:
Introduction. Attention to this problem is due to the low frequency of diagnosis of tracheal diverticula in clinical practice. There are a limited number of reports in the literature, mainly concerning uncomplicated cases. The development of high-resolution computed tomography has expanded the possibilities of determining rare pathologies of various localizations, and the use of X-ray contrast agents has increased the resolution of the image. In the context of the above, we present this rare clinical observation in order to focus the attention of specialists on the importance and relevance of a detailed examination of patients with recurrent respiratory complaints and a collegial approach to the management of such cases.
Purpose of the investigation. Evaluation of the feasibility of a multidisciplinary personalized concept to the diagnosis and treatment of tracheal diverticulum.
Materials and methods. The method of describing a clinical case, methods of descriptive statistics with the representation of discrete and continuous data.
Results and discussion. The clinical symptoms of this disease are pronounced, but nonspecific, since the complaints presented are characteristic of many diseases of the upper and lower respiratory tract. An endoscopic examination of the ENT organs revealed paresis of the right vocal fold, and therefore the patient was referred to a chest X-ray and to a pulmonologist for consultation. During the diagnostic search, a rare cause of this pathology was identified - a tracheal diverticulum. The tracheal diverticulum as a focus of latent tracheobronchial infection in this case is subject not only to conservative treatment, but also surgical, taking into account compression of neighboring structures and repeated episodes of infection. An MRI of the mediastinum with contrast in this case confirmed the result of CT diagnostics, and also allowed to detail the area of interest and give a deeper understanding of the volume of the lesion and reactive changes. Due to the resolution and specificity of this diagnostic method, its use seems promising for the examination of patients with similar described symptoms, including to reduce the dose of radiation exposure. MRI can be used as an additional diagnostic method.
Conclusion. The application of a multidisciplinary personalized approach to the cause of unilateral paresis of the vocal fold in the presence of an anamnesis of recurrent respiratory tract infections with a prolonged course and nonspecific complaints, including from the gastrointestinal tract, made it possible to identify the presented clinical observation not only as a rare case, but as the result of a targeted diagnostic search.
Keywords paresis of the vocal fold, hoarseness of the voice, cough, tracheal diverticulum, choking on food, computed tomography, magnetic resonance imaging
Bibliographic reference:
M. Y. Savina, D. A. Gusarova, T. V. Bolshova, O.V. Medvedeva, TRACHEAL DIVERTICULUM AS A RARE CAUSE OF UNILATERAL PARESIS OF THE VOCAL FOLD: MULTIDISCIPLINARY PERSONALIZED APPROACH TO DIAGNOSIS AND TREATMENT // Scientific journal «Current problems of health care and medical statistics». - 2024. - №3;
URL: http://healthproblem.ru/magazines?textEn=1363 (date of access: 31.10.2024).
URL: http://healthproblem.ru/magazines?textEn=1363 (date of access: 31.10.2024).
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