Acute airway obstruction from a laryngeal lymphangioma in a child

Lymphangiomas present commonly in the head and neck region with over 90% of lesions diagnosed before 2 years of age. These lesions have rarely been reported as a cause of acute upper airway obstruction and to date, there are very few reports in the literature documenting the presence of lymphangiomas in the larynx. We present the case of a previously asymptomatic 13-year-old girl with Joubert's syndrome, who presented with acute airway obstruction while undergoing extubation for a routine dental procedure. Near-complete obstruction of her supraglottis from a lymphangioma necessitated tracheotomy to secure the airway. The diagnostic work-up and management of this patient and her post-operative course are discussed. This case illustrates the insidious presentation of a laryngeal lymphangioma and emphasizes the management options for such patients.