SUDDEN ONSET APHONIA CAUSED BY A JAPANESE-STYLE BATH

An 86-year-old man was referred by his family physician to our clinic because of sudden onset aphonia immediately after a Japanese-style bat h. On examination, the only abnormality was aphonia, with an otherwise normal physical examination. However, we found vocal fold oedema on l aryngeal fibrescopy. For treatment, he was immediately given 30 mg pre dnisolone intravenously. Twelve hours after injection the oedema had c ompletely disappeared and his aphonia had resolved. The patient was he althy for three months after returning home. However, at the beginning of a cold winter night he again complained of sudden onset hoarseness , after taking a Japanese-style bath. Japanese-style baths are complet ely different from Western-style baths. There is a temperature differe nce of almost 30 degrees C between the inside and outside of a bath; t he transition may represent a type of physical exercise in elderly and exhausted individuals. This difference could cause a cold or heat-ind uced allergic reaction. We strongly recommend a laryngeal study in cas e of sudden onset aphonia.