A case of school-age onset laryngomalacia successfully treated with a resection of excess arytenoid mucosa

Abstract

Laryngomalacia is one of the common causes of inspiratory stridor in newborns and infants. In contrast, there are few reports of acquired laryngomalacia in school-age children and adolescents. We report a case of a school-age boy with aryepiglottic fold type laryngomalacia that responded well to surgical treatment. Endoscopic examination revealed an inward prolapse of the bilateral excess arytenoid mucosa and shortened aryepiglottic folds. When conservative treatment fails, surgical treatment is recommended for acquired laryngomalacia. In our patient, the symptoms improved after supraglottoplasty, namely resection of the excess mucosa and dissection of the hemilateral aryepiglottic fold. Postoperatively, he recovered from inspiratory stridor, but still experienced intermittent cough. He was diagnosed with voice tics and treated by a psychiatrist. His inspiratory dyspnea has been successfully relieved so far. Since there are very few reports of laryngomalacia in school-age children in Japan, this condition may be misdiagnosed. However, otorhinolaryngologists should recognize laryngomalacia as a differential disease causing inspiratory stridor, accurately diagnose it using endoscopic examination, and provide appropriate treatment.