Correct!
4. 1 and 3
CT scan is not unreasonable if looking for a goiter but is unlikely to show VCD. Both ENT and pulmonologists can evaluate the upper airway. A series of maneuvers is often done to elicit VCD if it is not readily apparent (5). However, the vocal cords appeared normal and there appeared to be a web obstructing the trachea (Figure 3).
Figure 3. Photos taken through the bronchoscope. A: normal appearing vocal cords which adducted normally. B: view from just below the vocal cords of a tracheal web (arrow) obstructing much of the trachea.
The adult fiberoptic bronchoscope (outer diameter 6 mm) could not be passed beyond the web.
What should be done next? (Click on the correct answer to be directed to the seventh and final page)