859 Bilateral Vocal Cord Palsy Secondary to Rheumatoid Arthritis: A Case Report

Abstract Introduction Rheumatoid arthritis (RA) affects the larynx in 13-75% of cases and is usually subclinical. Airway obstruction due to vocal cord fixation occurs late RA presents as an inspiratory stridor. Case presentation An 85-year-old woman presented A&E Resus with tachypnoea, stridor drowsiness. ABG showed hypercapnic respiratory failure. A flexible nasendoscopy was performed which revealed adducted cords paradoxical breathing. The patient had been admitted a similar before attributed her longstanding RA. Potential surgical options including tracheostomy, lateralisation cord/arytenoid removal were considered but ultimately, these deemed unsuitable for patient. Conclusions Stridor life-threatening complication that has viable tracheostomy lateralisation; however, appropriateness such procedures should always be correlated patient’s clinical status background.