Differential Diagnosis for a 65-year-old Patient with Difficulty Breathing, Stridor, and Vocal Cord Paralysis after C-Spine Surgery
- Single most likely diagnosis:
- Bilateral Vocal Cord Paralysis: This is the most likely diagnosis given the patient's symptoms of difficulty breathing, stridor, and vocal cord paralysis. The recent c-spine surgery could have caused injury to the recurrent laryngeal nerves, leading to vocal cord paralysis.
- Other Likely diagnoses:
- Laryngospasm: This could be a possible diagnosis, especially if the patient has a history of laryngospasm or has been experiencing anxiety or stress. However, the presence of vocal cord paralysis makes this less likely.
- Airway Edema: Post-operative airway edema could be causing the patient's difficulty breathing and stridor. This is a common complication after surgery, especially if the patient has been intubated.
- Hematoma: A hematoma in the neck could be compressing the airway, leading to difficulty breathing and stridor. This is a possible complication after c-spine surgery.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Airway Obstruction: This is a life-threatening condition that requires immediate attention. The patient's difficulty breathing and stridor could be signs of an obstructed airway.
- Pneumothorax: A pneumothorax could be causing the patient's difficulty breathing and could be a complication of the c-spine surgery or the traumatic injury.
- Pulmonary Embolism: This is a possible diagnosis, especially if the patient has been immobile for a period of time. A pulmonary embolism could be causing the patient's difficulty breathing.
- Rare diagnoses:
- Laryngeal Fracture: This is a rare but possible diagnosis, especially if the patient has a history of trauma to the larynx. A laryngeal fracture could be causing the patient's vocal cord paralysis and difficulty breathing.
- Tracheal Stenosis: This is a rare complication of intubation or tracheostomy. The patient's difficulty breathing and stridor could be signs of tracheal stenosis.