Supraglottic Obstruction in an Adult with Inspiratory Arytenoid Cartilage Prolapse

The most common cause of stridor and dyspnea in infants is LM. The nominal derivation of this congenital condition arises from the Greek word “malakia”, which refers to morbid softening of an organ part. It has been sub-classified into 3 primary variants: Type 1 is characterized by antero-medial prolapse or collapse of the bodies of the arytenoid cartilages over the laryngeal inlet. In Type 2, the antero-posterior dimension of the airway is significantly reduced by abnormally short aryepiglottic folds. The Type 3 form involves abnormal degrees of posterior deflection of the epiglottis during inspiratory aerodynamics, which results in pronounced narrowing of the laryngeal lumen [1]. In the vast majority of these cases, watchful surveillance is indicated as the treatment of choice, owing to the probability of gradual spontaneous resolution of signs and symptoms without medical-surgical management. For those children with intractable LM several surgical approaches have been successfully employed, including lengthening the aryepiglottic folds and de-bulking or anchoring redundant supraglottic mucosa and/or cartilage [2-4].