Acquired airway obstruction from histologically normal, abnormally mobile supraglottic soft tissues

In patients with nonmalignant upper aerodigestive tract abnormalities such as cysts, neoplasms, and laryngomalacia, airway obstruction has been described as a function of not only size and location of abnormal structures, but also of their mobility. This paper describes three patients who developed upper airway restriction with stridor due to abnormally redundant and mobile, but histologically normal, supraglottic mucosa. The specific mechanism of and structures involved in obstruction were clearly defined by videolaryngopharyngoscopy. Endoscopic microdissection and/or laser excision of the redundant supraglottic mucosa restored airway patency and completely relieved the obstructive respiratory symptoms. The pulsion effects of inspiratory airflow are postulated as the cause of these acquired lesions. Recommended treatment is reviewed.