Question: A 72 year old woman undergoes open tricuspid valve repair. On postoperative day 1, she is found to have a weak, breathy cough. Aspiration of thin liquids is noted on a videofluoroscopic swallow study. Fiberoptic evaluation of the larynx reveals left true vocal fold immobility. Which of the following is the next best step in management?

a) CT of skull base to aortic arch

b) Injection laryngoplasty with calcium hydroxyapatite into Reinke’s space

c) Injection laryngoplasty with carboxymethylcellulose based agent lateral to thyroarytenoid muscle

d) Arytenoid adduction

[Answer will be posted with next week's new question]

Answer to last week's question, “Around The Ear” (September 20, 2021)

B - Enucleation.

Bär B, Mantsopoulos K, Iro H. Paradigm shift in surgery for benign parotid tumors: 19 years of experience with almost 3000 cases. Laryngoscope. 2020 Aug;130(8):1941-1946. doi: 10.1002/lary.28454. Epub 2019 Dec 5. PMID: 31804719.