Fall 2008

Counting Sheep, Not Coughs

They found a mass the size of a blueberry protruding from his larynx, or voice box. When he lay down, the mass flipped down into his trachea, obstructing his breathing.

Ear, nose and throat specialist Dr. Lee Kleiman explains the results of a videostroboscopy to a patient.

For most people, nighttime is for recharging tapped energy reserves. But for 56-year-old Gambrills resident Armstead Farrar, nights were spent in fear—fear of choking, of waking up unable to breathe, of watching the clock cruelly tick toward another dawn without a wink of sleep.

“Night after night for nearly a year, I didn’t sleep in my own bed,” he recounted. “I had to sleep in a chair, or sitting upright with my back leaned against a wall. I was miserable.”

Tired of waking up hour after hour, night after night, Mr. Farrar visited several physicians at Washington and Baltimore hospitals, and was diagnosed with either sleep apnea or acid reflux. When remedies for those conditions didn’t solve his problem, he doggedly resumed his search for help.

“When my doctor finally sent me to Anne Arundel Medical Center, I thought it would be another trip to another hospital and another doctor telling me they couldn’t figure out what was wrong,” he said. “When that Dr. Kleiman diagnosed the growth on my vocal cord,” he says with a laugh, “well, my life suddenly got a whole lot better.”

“That Dr. Kleiman” is Lee A. Kleiman, M.D., an AAMC ear, nose, and throat specialist (ENT) with Severn River ENT Plastic and Laser Surgery in Annapolis and Severna Park. Dr. Kleiman suspected the sleeping problems were a symptom and not an end result. “I had a patient with hoarseness, shortness of breath, trouble sleeping,” he said. “At AAMC, ENTs have the AAMC Voice and Swallowing Center as a resource, so I sent Mr. Farrar there for tests. The problem was evident immediately.”

Dr. Kleiman and the voice and swallowing team used a videostroboscopy to examine Mr. Farrar’s throat. They found a mass the size of a blueberry protruding from his larynx, or voice box. When he lay down, the mass flipped down into his trachea, obstructing his breathing. When he talked, the air rushed up from his lungs, pushing the mass into his voice box, disrupting his speech and breathing.

“The mass was benign, which was a relief to Mr. Farrar,” said Dr. Kleiman. “I operated minimally invasively and removed the growth while not disrupting the underlying muscle of the throat and preserving the lining over the top of those muscles. His throat suffered minimal surgical trauma and it was all done through the mouth, with no incision on the throat itself.”

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