Diagnosing aerodynamic supraglottic collapse with rest and exercise flexible laryngoscopy.
OBJECTIVE
Laryngomalacia is best known as a self-resolving infantile disorder characterized by inspiratory stridor with occlusion of the larynx by collapse of arytenoid tissues due to Bernoulli forces. Adult laryngomalacia has been sporadically described in the literature. We identified a series of patients with aerodynamic supraglottic collapse mimicking laryngomalacia in our Otolaryngology clinic.


METHODS
Case series.


METHODS
A series of five patients from our Otolaryngology clinic with aerodynamic supraglottic collapse presented with complaints ranging from noisy breathing to dyspnea with exertion. Diagnosis was made using rest and exercise flexible laryngoscopy.


RESULTS
Symptoms resolved in all patients who underwent traditional or modified supraglottoplasty.


CONCLUSIONS
These patients, all with abnormal corniculate/cuneiform motion occluding the airway during forceful inspiration, reinforce the diagnostic role of rest and exercise flexible laryngoscopy in patients with dyspnea and stridor. These results may suggest that aerodynamic supraglottic collapse is an underdiagnosed clinical entity.
Department of Otolaryngology, Head & Neck Surgery, Brooke Army Medical Center, San Antonio, Texas, USA. greg.r.dion@us.army.mil
Gregory R
GR
Dion
Robert L
RL
Eller
Roy F
RF
Thomas
D000328:Adult; D004417:Dyspnea / Q000209:etiology; D004825:Epiglottis / Q000503:physiopathology* / Q000601:surgery; D005080:Exercise Test; D005260:Female; D006801:Humans; D001239:Inhalation; D055092:Laryngomalacia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D058753:Laryngoplasty; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012135:Respiratory Sounds / Q000209:etiology; D016896:Treatment Outcome