Author(s)
Saranya Reghunathan MD
Stephen Goldstein MD
Affiliation(s)
University of Arizona
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the larynx as a possible site of bleeding diathesis and explain the need for early diagnosis and management. Objectives: Highlight the larynx as potential location of bleeding diathesis and its subsequent clinical relevance. Study Design: Report of two cases and review of literature. Methods: Patient chart analysis and literature review. Results: Two patients presented to our institution with hoarseness, dysphagia, mild airway obstructive symptoms and known coagulopathies. Flexible fiberoptic laryngoscopy revealed vocal cord hemorrhage. Patient history suggested that neither patient had sustained recent trauma. Ultimately both patients were primarily treated with conservative measures, including rapid reversal of coagulopathy, voice rest, and proton pump inhibitors without any need for procedural intervention. Both patients resolved their vocal cord hemorrhage and returned to their normal voices on subsequent visits. Conclusions: Head and neck manifestations of coagulopathies are a known entity that frequently requires procedural management by otolaryngologists. However, the larynx as the solo manifestation of bleeding diathesis in a coagulopathic patient without direct trauma has not been clearly reported. This process requires early diagnosis and management by an otolaryngologist. We report two unusual cases of laryngeal bleeding diatheses without prior traumatic injury and subsequent medical management that prevented airway collapse.