A Case of Adult-Onset Arytenoid Type Laryngomalacia Successfully Treated with a Resection of Flaccid Arytenoid Mucosa

Abstract

Laryngomalacia is one of the most common diseases of laryngeal stenosis in newborns and infants. In contrast, adult-onset laryngomalacia cases are rare and the majority of them are classified as an epiglottic type. We report on a case of 20 -year old female with arytenoid type laryngomalacia who presented with an intermittent inspiratory stridor after catching a cold. Her pulmonary function was normal; however, endoscopic examination showed an inward prolapse of the bilateral flaccid arytenoid mucosa during strained inspiration resulting in supraglottic stenosis. She underwent a resection of the flaccid mucosa bilaterally with the use of CO 2 laser. Postoperatively, her inspiratory dyspnea had been successfully relieved for over a year. The rarity of adult-onset laryngomalacia may lead to overlooking the possibility of this disease. Physicians treating dyspneic patients should be aware of laryngomalacia even in adults and thorough endoscopic observation of the larynx should be mandatory.

Atypical Presentation of Severe Laryngomalacia Managed with Aryepiglottoplasty and A Novel Suture Technique

“…In view of the clinical picture of endoscopic finding of short aryepiglottic fold with long epiglottis and multiple failed attempts of extubation surgery was planned in the present case. Hey et al reported adult onset laryngomalacia in 2 patients [18] , Hyodo et al reported adult onset layngomalacia in a 20 year old female [19] and in this study we report the same in 12 year old male patient. Richter et al also reported a series of late onset laryngomalacia where 17 patients were diagnosed as having laryngomalacia when they were older than 2 years(mean age at onset 6.6 years) [20] .…”