A 10 year old boy developed hoarseness of voice following an attack of diphtheria. On examination, his Rt vocal cord was paralysed.The treatment of choice for paralysed vocal cord will be:
**Core Concept**
The question is testing the management of vocal cord paralysis, specifically in the context of a patient with a history of diphtheria. Vocal cord paralysis can result from various causes, including nerve damage, infection, or trauma.
**Why the Correct Answer is Right**
Diphtheria toxin can cause damage to the recurrent laryngeal nerve, leading to vocal cord paralysis. In this scenario, the treatment of choice for a paralysed vocal cord is voice therapy and vocal cord injection with calcium hydroxylapatite (Radiesse). This is because voice therapy can help improve vocal cord mobility and function, while vocal cord injection can provide temporary support and improve voice quality. Calcium hydroxylapatite is a popular choice for vocal cord injection due to its biocompatibility and long-lasting effects.
**Why Each Wrong Option is Incorrect**
**Option A:** Steroid injection is not the treatment of choice for paralysed vocal cord, although it may be used to reduce inflammation and swelling in the surrounding tissues.
**Option B:** Tracheostomy is a surgical procedure that may be required in cases of severe vocal cord paralysis, but it is not the primary treatment for a paralysed vocal cord.
**Option C:** Surgical repair of the recurrent laryngeal nerve may be considered in some cases, but it is not the first line of treatment for a paralysed vocal cord.
**Clinical Pearl / High-Yield Fact**
It's essential to note that vocal cord paralysis can be a complication of diphtheria, and prompt treatment is necessary to prevent long-term voice changes.
**Correct Answer: C. Vocal cord injection with calcium hydroxylapatite (Radiesse).**