instruction: hello doctor five weeks ago I fell down while mountain biking I went over the handlebars and hit my head and chest I was wearing a helmet and a chest protector and both of them had cracked as a result of the impact the helmet strap had strangulated my neck pretty hard ever since I have been continuously having sensation pressure at the place where the strap had impacted activities like turning my neck yawning laughing cause some pain over the past five weeks the symptoms have not improved I am very worried because I am afraid I might have to deal with this forever they did a it scan and said that it was normal should I ask for an mri could this be some kind of hernia
output: hi sorry to hear about your injury since your it computed tomography scan is normal it is very unlikely that there is any bony or skeletal injury hence reducing the possibility of something permanent it appears that there is some soft tissue injury in the laryngopharyngeal region or a cartilaginous injury that is resolving very slowly this indicates an injury closer to the voice box region because of constant movements during speech laughter and swallowing delay recovery this may also explain why it is taking so long to heal completely in my opinion an mri magnetic resonance imaging is certainly indicated since there has been no improvement in symptoms for five weeks and to look for cartilaginous injury or soft tissue lesions such as a granuloma or hematoma following trauma in addition a video laryngoscope performed by an ent will help to evaluate the voice box and supporting apparatus internally for any injury specifically the inter arytenoid region a hernia in the neck or a laryngocele may be a possibility following neck injury but seems very unlikely in your case since there is no visible bulge in the neck which worsens on coughing etc there may be an internal laryngocele that may be picked up on video laryngoscope I hope this helps