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Supraglottic Obstruction in an Adult with Inspiratory Arytenoid Cartilage Prolapse

Amy L Rutt, James P Dworkin and Noah Stern

Laryngomalacia (LM) has become the default diagnostic term for any patient who might struggle with stridor and dyspnea secondary to floppy, insufficient, hypotonic, or passively collapsing supraglottal tissue characteristics. Despite the increasing incidence of this diagnosis, the etiology, work-up, and pathophysiology of LM remain poorly understood and controversial to date.

Objectives: The purpose of this paper is to illustrate the history, unique physical examination findings, and multivaried and creative treatments rendered to an adult patient of ours who struggled with profound signs and symptoms of Type 1 LM.

Methods: This is a case study of idiopathic aerodynamic supraglottic collapse that occurred in an otherwise healthy individual who had no prior history of connective tissue disorder, neurodegenerative disorder, or trauma. The patient’s history, examination, treatment, and review of the literature are discussed.

Results: Laryngoscopy is the definitive test to evaluate supraglottic airway collapse. Supraglottoplasty is a safe and effective treatment for adult LM.

Conclusions: The diagnosis of adult aerodynamic supraglottic collapse is an important entity to consider in patients presenting with dyspnea, stridor, or other breathing complaints. This case description illustrates the importance of laryngoscopy when evaluating patients with such signs and symptoms.