Bilateral haemorrhagic vocal cords with supraglottic bruising following blunt laryngeal trauma.

Isolated vocal cord haemorrhage secondary to blunt neck trauma is rare. It can lead to compromised airway in a patient with otherwise minimal clinical findings. The authors report a patient with traumatic haemorrhage in the supraglottis and vocal cords. A 24 years old Caucasian male presented with acute hoarseness, dysphagia, and a tender anterior neck swelling 3 hours after he was punched in his neck. There was no stridor or surgical emphysema. Flexible pharyngolaryngoscopy revealed no endolaryngeal mucosal tear but evidence of bleeding into his true vocal cords. The patient was successfully treated with dexamethasone, analgesia and voice rest. The patient refused to stay in hospital for overnight airway monitoring. The authors believe that all patients presenting with a blunt neck trauma should undergo laryngoscopy for assessment and monitoring of the airway.

Nicorandil associated pinna ulceration: a new entity for an otolaryngologist.

Nicorandil induced ulceration is a phenomenon that is becoming increasingly recognised in clinical practice. However, most cases of Nicorandil induced ulcers appear at the muco-cutaneous interface zones. We report a case of Pinna ulceration where Nicorandil appeared to be the chief aetiological factor. Having ruled out all reasonable alternatives Nicorandil treatment was discontinued and a rapid improvement in the ulcer was observed. To the best of our knowledge this is the first recorded case of external ear ulceration related to Nicorandil use.