title: Upper airway obstruction due to a change in altitude: first report in fifty years.
abstract: BACKGROUND
  Air travel mostly causes minor ear, nose and throat complaints. We describe a second report in literature of airway obstruction caused by a drop in atmospheric pressure during a routine commercial flight.
  
  
  METHODS
  A 54-year-old male was referred to a head and neck surgeon with a 2 cm left submandibular mass that would enlarge during commercial flights. As the plane gained elevation, the mass would grow and cause him to become stridorous and short of breath. The shortness of breath and stridor would only resolve upon landing of the plane. A CT scan showed a large air sac extending from the larynx at the level of the true vocal cords up to the angle of the mandible. Based on the history and the CT findings a diagnosis of a laryngocele was made. The laryngocele was excised using an external approach, resolving the patient's difficulty with flying.
  
  
  CONCLUSIONS
  This article reports a rare case of upper airway obstruction caused by atmospheric pressure changes during air travel. The reported case is of significance as only a few uncomplicated laryngoceles have been reported to cause airway distress in the literature. This report highlights the epidemiology, presentation, complication and management of laryngoceles.
authors.affiliation: Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Vancouver General Hospital & University of British Columbia, Vancouver, BC, Canada. butskiy.alex@gmail.com.
authors.forename: Oleksandr
authors.initials: O
authors.lastname: Butskiy
authors.affiliation: Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Vancouver General Hospital & University of British Columbia, Vancouver, BC, Canada. dwa@shaw.ca.|Gordon & Leslie Diamond Health Care Centre, 4th. Fl. 4299B-2775 Laurel Street, Vancouver, BC, V5Z 1 M9, Canada. dwa@shaw.ca.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Anderson
mesh_terms: D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D000531:Altitude; D000532:Altitude Sickness / Q000150:complications*; D006801:Humans; D059608:Laryngocele / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
references.citation: J Assoc Res Otolaryngol. 2013 Oct;14(5):623-33
references.pmid: 23887775
references.citation: Ugeskr Laeger. 2012 Nov 5;174(45):2811
references.pmid: 23304708
references.citation: Laryngoscope. 1991 May;101(5):529-36
references.pmid: 2030634
references.citation: Acta Otorhinolaryngol Ital. 2012 Feb;32(1):58-62
references.pmid: 22500070
references.citation: J Laryngol Otol. 1975 Sep;89(9):915-24
references.pmid: 1176826
references.citation: Clin Otolaryngol Allied Sci. 2004 Oct;29(5):492-6
references.pmid: 15373862
references.citation: Biomed Res Int. 2014;2014:819453
references.pmid: 24729979
references.citation: J Forensic Sci. 2015 Mar;60(2):518-20
references.pmid: 25556289