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Name of sign of laryngeal crepitus

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laryngeal crepitus named sign clinical examination

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laryngeal crepitus "Muller sign" OR "Bosworth sign" OR "Krönlein sign" named sign retropharyngeal pathology

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loss of laryngeal crepitus retropharyngeal abscess "Bosworth" sign ENT

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Found it clearly in the authoritative textbook. The answer is:

Trotter's Sign

The loss of laryngeal crepitus is called Trotter's sign.
  • What it means: Normally, when the larynx is moved laterally against the prevertebral fascia, a grating/crunching sensation (crepitus) is felt. If this crepitus is absent, it indicates that something is filling the prevertebral/retropharyngeal space - most classically, a nasopharyngeal carcinoma that has invaded and fixed the prevertebral fascia.
  • Clinical significance: Loss of laryngeal crepitus (Trotter's sign), along with restriction of neck extension, implies involvement of the prevertebral fascia - a sign of advanced posterior spread of nasopharyngeal or posterior pharyngeal wall tumors.
As stated in Scott-Brown's Otorhinolaryngology Head & Neck Surgery:
"Loss of laryngeal crepitus (Trotter's sign) and restriction of neck extension may imply involvement of the prevertebral fascia."
Note: Trotter's syndrome (named after the same surgeon, Wilfred Trotter) also refers to a triad of symptoms from nasopharyngeal carcinoma: unilateral conductive hearing loss, trigeminal neuralgia, and palatal palsy - but the specific sign of loss of laryngeal crepitus is the clinical examination finding called Trotter's sign.
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