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Anterior fracture dislocation of the odontoid peg in ankylosing spondylitis as a cause for rhinolalia clausa: a case study

Published online by Cambridge University Press:  30 April 2007

J M Hilton ,
P Tassone ,
J Hanif  and
B Blagnys
J M Hilton*
Affiliation:
ENT DepartmentNorfolk and Norwich University Hospital, Norwich, UK
P Tassone
Affiliation:
ENT DepartmentNorfolk and Norwich University Hospital, Norwich, UK
J Hanif
Affiliation:
ENT DepartmentNorfolk and Norwich University Hospital, Norwich, UK
B Blagnys
Affiliation:
Speech and Language Department, Norfolk and Norwich University Hospital, Norwich, UK
*
Address for correspondence: J M Hilton, 48 Pightle Way, Lyng, Norwich, NR9 5RL, UK. Fax: 44 1603 287288 E-mail: jenniferhilton@supanet.com
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Abstract

We present an unusual cause of rhinolalia clausa secondary to an oropharyngeal mass. A 69-year-old male presented to the otorhinolaryngology clinic with a one year history of a ‘plummy’ voice. He had a longstanding history of severe ankylosing spondylitis. Examination revealed an obvious hyponasal voice and a smooth hard mass in the midline of the posterior nasopharyngeal and oropharyngeal walls. Subsequent computed tomography scans and lateral plain neck X-ray showed a fracture dislocation of the odontoid peg, secondary to ankylosing spondylitis, which had eroded through the body of the C1 vertebra to lie anteriorly, resulting in the aforementioned impression into the pharyngeal mucosa. The radiological images, the role of the nasal airways in phonation and the causes of hyponasal speech are discussed.

Keywords

Speech DisordersOdontoid ProcessNasal ObstructionNasopharynxAnkylosing Spondylitis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 105 - 107
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Presented in précised form as a poster presentation at the British Rhinology Society Meeting in 18 May 2006, Swansea, UK.

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