Diagnosing Aerodynamic Supraglottic Collapse With Rest and Exercise Flexible Laryngoscopy

Surgical treatment of a case of adult epiglottic laryngomalacia

“…It is usually associated with trauma, surgery, neurologic lesions or degenerative disease such as Parkinson's, amyotrophic lateral sclerosis or support tissue disease such as Elhers-Danlos syndrome [1].…”

“…It may be secondary to trauma, surgery, neurologic lesion, degenerative disease (Parkinson's disease, amyotrophic lateral sclerosis, support tissue disease such as Elhers-Danlos syndrome) or idiopathic, without discernible medical cause [1,2].…”

Adult obstructive sleep apnoea and the larynx

“…Congenital laryngomalacia is a well described entity in the paediatric population with contributing factors including laryngeal hypotonia with poor neurological control, redundant laryngeal soft tissue, and weak cartilaginous support; however, this condition usually spontaneously resolves within 18 months [25]. Adult laryngomalacia is less frequently described and seems to be related to dynamic supraglottic collapse during high airflow states and rarely at rest and is best identified on exercise laryngoscopy [26]. Most cases associated with OSA seem to be related to preceding neurological injury with reported improvement of the condition seen after supraglottoplasty or spontaneous recovery of the underlying neurological condition [25].…”

The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

“…As mentioned in the introduction, exercise-induced laryngomalacia is considered one cause of dyspnea (Christopher & Morris, 2010;Dion, Eller, & Thomas, 2012;Heinle et al, 2003;Richter, Rutter, deAlarcon, Orvidas, & Thompson, 2008;Røksund et al, 2009;Tervonen et al, 2009). To examine the present data for laryngomalacia, the primary investigator retrospectively reviewed laryngoscopic examinations of the athletes with PVFMD after the exercise challenge to determine whether symptoms were related to prolapsed laryngeal and supralaryngeal structures.…”

“…However, these findings mirror those of Røksund et al (2009), who examined 113 athletes with exercise-induced dyspnea during exercise and identified 21 who demonstrated laryngomalacia only, 88 with laryngomalacia followed by vocal fold adduction, and four with vocal fold adductory motion only. For those athletes with laryngomalacia during exercise, high airflow rates in conjunction with the negative pressure associated with the Bernoulli effect appeared to contribute to prolapse of the laryngeal structures, thus constricting the laryngeal airway (Dion et al, 2012). Interviews with athletes with PVFMD often reveal that they experienced occasional episodes suggestive of PVFMD at much younger ages when on the playground or in physical education class.…”