Larynx: unilateral vocal fold palsy: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Larynx: unilateral vocal fold palsy

Sample item

A man develops a breathy voice and aspiration of thin liquids immediately after a lobectomy and a left vocal cord is in the paramedian position with a gap on phonation. What is the best early management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Voice therapy and temporary injection laryngoplasty

Unilateral palsy is managed first with speech therapy and, for glottic gap with aspiration, temporary injection medialisation (for example hyaluronic acid) while waiting for recovery. Permanent medialisation thyroplasty is reserved for persistent palsy after about 6 to 12 months.

Option by option

  • A. Immediate tracheostomy

    Tracheostomy is for bilateral palsy with airway compromise.

  • B. Total laryngectomy

    Laryngectomy is not indicated.

  • C. Cricothyroid approximation only

    Cricothyroid approximation changes pitch but does not close the gap.

  • D. Voice therapy and temporary injection laryngoplasty (correct)

    Correct. Therapy and temporary injection medialise the cord while recovery is awaited.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Voice therapy and temporary injection laryngoplasty. Unilateral palsy is managed first with speech therapy and, for glottic gap with aspiration, temporary injection medialisation (for example hyaluronic acid) while waiting for recovery.

Why is "Immediate tracheostomy" not the answer?

Tracheostomy is for bilateral palsy with airway compromise.

Why is "Total laryngectomy" not the answer?

Laryngectomy is not indicated.

Why is "Cricothyroid approximation only" not the answer?

Cricothyroid approximation changes pitch but does not close the gap.

What concept does this question test?

It tests Larynx: unilateral vocal fold palsy in ENT. Permanent medialisation thyroplasty is reserved for persistent palsy after about 6 to 12 months.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Larynx: unilateral vocal fold palsy?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.