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Unique presentation of cricoid cartilage fracture causing intermittent dyspnea without preceding trauma.
Nagoya J Med Sci. 2019 Nov; 81(4):687-691.NJ

Abstract

Cricoid cartilage fracture is generally caused by significant neck trauma and causes continuous dyspnea, neck pain, or hoarseness developing immediately after the traumatic episode. A 69-year-old woman without any history of trauma was admitted to our hospital with intermittent dyspnea. Six months before admission she had started to complain of dyspnea occurring several times a month without warning, improving spontaneously within a few hours without treatment. Her primary care doctor diagnosed asthma and she was treated with inhaled short-acting beta agonists and glucocorticoids, without improvement. On initial evaluation at our hospital, the cause of dyspnea was unclear. Laryngoscopy was performed, which excluded vocal cord dysfunction. A further attack of dyspnea occurred on the fourth admission day. Stridor was evident during the attack, and bronchoscopy revealed subglottic narrowing of the trachea on both inspiration and expiration with no mass or foreign objects. Computed tomography (CT) of the neck revealed cricoid cartilage fracture causing airway narrowing and dyspnea. She was orally intubated, and tracheostomy was performed 2 weeks later to maintain her airway, which resolved her dyspnea. This patient's presentation was unique in two aspects. First, there was no history of trauma that may cause her cricoid cartilage fracture. Second, her symptoms of dyspnea were intermittent rather than continuous. These aspects led to suspicions of other diseases such as asthma or vocal cord dysfunction, thus delaying the diagnosis. Cricoid cartilage fracture should be considered in patients with dyspnea of unknown cause, irrespective of continuous or intermittent symptoms and preceding traumatic episodes.

Authors+Show Affiliations

Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. Department of General Medicine/Family and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31849386

Citation

Matsuo, Yuichiro, et al. "Unique Presentation of Cricoid Cartilage Fracture Causing Intermittent Dyspnea Without Preceding Trauma." Nagoya Journal of Medical Science, vol. 81, no. 4, 2019, pp. 687-691.
Matsuo Y, Yamada T, Hiraoka E. Unique presentation of cricoid cartilage fracture causing intermittent dyspnea without preceding trauma. Nagoya J Med Sci. 2019;81(4):687-691.
Matsuo, Y., Yamada, T., & Hiraoka, E. (2019). Unique presentation of cricoid cartilage fracture causing intermittent dyspnea without preceding trauma. Nagoya Journal of Medical Science, 81(4), 687-691. https://doi.org/10.18999/nagjms.81.4.687
Matsuo Y, Yamada T, Hiraoka E. Unique Presentation of Cricoid Cartilage Fracture Causing Intermittent Dyspnea Without Preceding Trauma. Nagoya J Med Sci. 2019;81(4):687-691. PubMed PMID: 31849386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unique presentation of cricoid cartilage fracture causing intermittent dyspnea without preceding trauma. AU - Matsuo,Yuichiro, AU - Yamada,Toru, AU - Hiraoka,Eiji, PY - 2019/12/19/entrez PY - 2019/12/19/pubmed PY - 2019/12/19/medline KW - cartilage fractures KW - cricoid cartilage KW - paroxysmal dyspnea SP - 687 EP - 691 JF - Nagoya journal of medical science JO - Nagoya J Med Sci VL - 81 IS - 4 N2 - Cricoid cartilage fracture is generally caused by significant neck trauma and causes continuous dyspnea, neck pain, or hoarseness developing immediately after the traumatic episode. A 69-year-old woman without any history of trauma was admitted to our hospital with intermittent dyspnea. Six months before admission she had started to complain of dyspnea occurring several times a month without warning, improving spontaneously within a few hours without treatment. Her primary care doctor diagnosed asthma and she was treated with inhaled short-acting beta agonists and glucocorticoids, without improvement. On initial evaluation at our hospital, the cause of dyspnea was unclear. Laryngoscopy was performed, which excluded vocal cord dysfunction. A further attack of dyspnea occurred on the fourth admission day. Stridor was evident during the attack, and bronchoscopy revealed subglottic narrowing of the trachea on both inspiration and expiration with no mass or foreign objects. Computed tomography (CT) of the neck revealed cricoid cartilage fracture causing airway narrowing and dyspnea. She was orally intubated, and tracheostomy was performed 2 weeks later to maintain her airway, which resolved her dyspnea. This patient's presentation was unique in two aspects. First, there was no history of trauma that may cause her cricoid cartilage fracture. Second, her symptoms of dyspnea were intermittent rather than continuous. These aspects led to suspicions of other diseases such as asthma or vocal cord dysfunction, thus delaying the diagnosis. Cricoid cartilage fracture should be considered in patients with dyspnea of unknown cause, irrespective of continuous or intermittent symptoms and preceding traumatic episodes. SN - 2186-3326 UR - https://www.unboundmedicine.com/medline/citation/31849386/Unique_presentation_of_cricoid_cartilage_fracture_causing_intermittent_dyspnea_without_preceding_trauma L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31849386/ DB - PRIME DP - Unbound Medicine ER -