Dr. Syed Peerzada Tehmid Ul Haque
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I was just hit on the right side of my neck with a basketball. Part of the basketball hit my chin, so my neck cartilage did not take the entirety of the impact. The basketball was probably traveling around 20 mph, I do not know for sure. As a large object, it probably did not exert that much pressure per area. Regardless, it happened in a fraction of a second. I do not have any noticeable wheezing or any hoarseness right now. However, I have some mild shortness of breath. I do not know whether this is related. Because I also have asthma and silent reflux, I have a pulse oximeter and a peak flow meter, both values of which are normal presently. I have some mild neck pain too. My cough is normal (no blood), and I do not have any difficulty swallowing. Can I wait a couple of weeks to get an indirect nasal laryngoscopy from an ENT in my area, and then depending on the result, symptoms then, get a CT/MRI a week thereafter? Or should I go seek emergency medical care now?
Hello,
Welcome to icliniq.com.
Normally larynx is well protected by protruding mandible. Most of the impact is received by the sturdy mandible. However, since the impact was on the side of the neck, the laryngeal framework might have received some impact. I would like you to palpate your neck for tenderness and if you can also feel for crepitus of the thyroid cartilage if any. Also, look for any swelling. If there is anything like that or if you develop any hoarseness or dyspnea you may pay a visit to ER. In the absence of these, you can wait and take some analgesics in the meanwhile.
Patient's Query
Hello doctor,
Thank you. I do not have any crepitus nor any visible swelling. I also do not have hoarseness or wheezing, but I do have some mild shortness of breath. Right now, I am seeing a specialist in a week for an indirect nasal laryngoscopy. My pulse oximetry is 97 %, and my peak flow meter for my asthma is 134.21 to 144.74 gal per minute, which is in my normal range as my best is 147.37 gal per minute? Would any internal swelling that I have now go unnoticed in a laryngoscopy a week from now? Would it be best to go to the ER right now, 36 hours post-injury to undergo an indirect laryngoscopy, and if necessary, have a CT scan thereafter given my mild shortness of breath currently?
Hi,
Welcome back to icliniq.com.
Since it has been 36 hours any laryngeal trauma leading to edema would have manifested by now. Since you do not have any symptoms you are less likely to have had any internal laryngeal trauma. In any case, the treatment is conservative with wait and watch policy. However one has to keep a watch for any breathlessness because the only emergency in laryngeal trauma is airway management. There is no need to panic. Just in case there is any worsening of breathlessness pay a visit to the ER. Since you are asthmatic you must be using some steroid inhalers. Steroids are the mainstay for the management of mild laryngeal edema.
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Otolaryngology (E.N.T)
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