A 70 years old male patient who is chronic smoker presented with complaints of change of voice since 3 months. It is
also associated with mild difficulty in swallowing. He has been taking over the counter medications since 3 months but has
not seen any improvement in the symptoms. Since past one week attendants have noted that he has mild noise while taking
breath.
a. What is your diagnosis?
b. What investigations would you order?
c. What medications would you prescribe?
d. What will the further management plan?
e. What surgical intervention would you advise to the patient?

Diagnosis: Based on the patient's symptoms of change in voice, mild difficulty in swallowing, and the presence of noise while breathing, the primary concern is a possible laryngeal or vocal cord pathology. Considering the patient's history of chronic smoking, a likely diagnosis could be laryngeal cancer. However, to confirm the diagnosis and determine the extent of the disease, further investigations are necessary.

Investigations:

1. Laryngoscopy: This procedure allows direct visualization of the larynx and vocal cords, helping to identify any lesions or abnormalities. Laryngoscopy can be performed using a flexible or rigid scope, depending on the patient's condition and the clinician's preference.

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