Successful CO2 laser ablation of true vocal fold microaneurysm in a patient with Ehlers-Danlos syndrome.

E hlers-Danlos syndrome (EDS) is a heterogeneous group of inherited connective tissue disorders composed of 6 major forms under the Villefranche classification: classic, hypermobility, vascular, kyphoscoliosis, arthrochalasia, and dermatoparaxis. Vascular type, or type IV, is diagnosed clinically by easy bruising, characteristic facial features, visible veins, and arterial/visceral rupture. It is an autosomal dominant disorder due to a mutation in the gene for type III procollagen (COL3A1). Affected patients have a decreased life expectancy, with a median survival of 48 years. Most mortalities result from arterial or visceral rupture. Although not a main feature of EDS, dysphonia has been reported in all subtypes of the disease at a significantly higher frequency than the general population. Dysphonia in this population may be secondary to impairment of vocal fold mobility or hemorrhagic infiltration of Reinke space. We present a patient with vascular EDS with recurrent vocal fold hemorrhage who underwent successful treatment by microflap excision and CO2 laser ablation of true vocal fold (TVF) microaneurysm. This is the first reported successful therapeutic intervention for laryngeal abnormality in a patient with EDS demonstrating that additional care should be considered when addressing hemorrhagic polyps in such patients. This case report was exempt from institutional review board approval.