Relearn the clinical skills: Missed case of bilateral vocal
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Introduction:
Vocal cord paralysis is a feature of numerous diseases with either neurogenic or mechanical causes. Hence, clinical diagnosis of the underlying pathology leading to paralysis of the vocal cords is necessary for further management.[1] Bilateral vocal cord paralysis which was misdiagnosed as bronchial asthma on several circumstances had been reported in the literature.[2,3] Here, we report another missed case of bilateral vocal cord paralysis and its root cause analysis (RCA).

Case
A 55-year-old male presented to our hospital with complaints of abdominal pain associated with intermittent episodes of vomiting for 1 year. On evaluation, he was diagnosed to have carcinoma stomach. Apart from this, he was a known case of bronchial asthma for 25 years, not on regular treatment. The recent exacerbation was 2 months earlier which was treated by salbutamol metered dose inhaler (MDI). On admission to our hospital, he was started on salbutamol nebulisation by the surgical team. After pulmonology opinion, he was started with Seroflo™ (salmeterol and fluticasone) MDI...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989812/?report=reader#!po=35.7143
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