Diagnosing aerodynamic supraglottic collapse with rest and exercise flexible laryngoscopy

Area of Science:

• Otolaryngology
• Respiratory Medicine
• Anatomy

Background:

• Laryngomalacia is typically an infantile disorder involving inspiratory stridor due to Bernoulli forces causing laryngeal collapse.
• Adult laryngomalacia is rarely described, often presenting with symptoms mimicking other conditions.

Observation:

• A series of five adult patients presented with noisy breathing or exertional dyspnea.
• Flexible laryngoscopy during rest and exercise revealed aerodynamic supraglottic collapse.
• Patients exhibited abnormal corniculate/cuneiform motion obstructing the airway during forceful inspiration.

Findings:

• All five patients experienced symptom resolution following supraglottoplasty (traditional or modified).

Implications:

• Aerodynamic supraglottic collapse may be an underdiagnosed cause of dyspnea and stridor in adults.
• Rest and exercise flexible laryngoscopy are crucial for diagnosing this condition.
• Supraglottoplasty offers an effective treatment for aerodynamic supraglottic collapse.