935 Stridor in Multiple System Atrophy: An Otolaryngologist Perspective

Abstract Background Bilateral vocal cord paralysis is a rare emergency presentation for Parkinson's disease (PD) but an acknowledged complication of atypical rarer form PD called Multi system atrophy ( MSA). MSA neurodegenerative disorder comprising autononic failure, cerebellar ataxia and parkinsonism. An early occurence stridor can indicate shorten survival quality life remains uncertain. Airway definitive management this patient group pose dilemma the Otolaryngologist who may be asked to provide specialist opinion. Case: We present case 73 year old female developed mild stridor, hours after right sided hemiarthroplasty. On day 23 her admission, there was sudden airway deteoriation. The otolaryngology anasthetic team stablised conservatively with option non invasive ventilation. palsy observed on nasendoscopy 27, she eventually diagnosed showed partial response trial madopar. Both options tracheostomy laser cordotomy were avoided. She safely discharged follow up. Conclusions There gaps in literature towards unaminous consensus patients. However, raising awareness groups will strenghten decision making processes.