Floppy epiglottis together with extra-laryngeal mass causing an inducible laryngeal obstruction and hypoxemic event in an adult: A case report

Abstract

Floppy epiglottis in an adult is rare and often pathological. Airway obstruction caused by floppy epiglottis in an adult is rarely reported. Neck mass, however, can affect the airway in many ways; however, inducible upper airway obstruction by extra-laryngeal neck mass is hardly been reported. In most of the instances of inducible laryngeal obstruction, the tumor is found in and around the laryngeal inlet. Herein, we report such an unusual incident happened to a 40-year-old gentleman, a case of oral carcinoma for 3 months and a rapidly increasing swelling (6 × 5 cm) over the right side of the neck for 8 days. He presented to us for emergency tracheostomy with the feature of acute upper airway obstruction, unable to lie down; and having difficulty in breathing, desaturation, and chocking even in propped up position. The case highlights the importance of clinical findings and difficulties faced for airway management in such patients.

Adult Laryngomalacia: A Scoping Review

“…A total of 33 studies were included in our review 9‐11,19‐48 . A PRISMA diagram outlining our search is shown in Figure 1.…”

“…One study suggests that their patient's symptoms correlate with cases of ALM reported in the literature 25 . One study references ALM, but instead describes their patient as having “inducible laryngeal obstruction.” 33 Finally, Templer et al was the earliest description of this entity and does not use the term ALM specifically, but they do refer to similarities with congenital laryngomalacia in their discussion 9 …”

“…45 The remaining 13 patients from 11 studies had varying suspected etiologies that included traumatic, postsurgical, related to OSA, compression from a mass, or secondary to an inherited disease. 9,10,22,[24][25][26][27]33,35,38,44 Six studies specifically describe the patient's symptoms as adult or acquired larnygomalacia, 10,22,26,35,38,44 while 2 studies did not mention ALM in their description. 24,27 One study suggests that their patient's symptoms correlate with cases of ALM reported in the literature.…”