Idiopathic Posterior Glottic Diastasis: A Case Report

Area of Science:

• Otolaryngology
• Laryngology
• Vocal Cord Physiology

Background:

• Posterior glottic diastasis is typically caused by instrumental injury to the posterior glottis.
• This condition involves a gap between the vocal cords at the posterior commissure.
• It often results in voice disorders such as breathy dysphonia.

Observation:

• An 18-year-old male presented with persistent breathy dysphonia.
• Initial treatments, including injection medialization, were ineffective.
• Comprehensive evaluation revealed posterior glottic insufficiency without a history of instrumentation.

Findings:

• The patient was diagnosed with idiopathic posterior glottic diastasis.
• This diagnosis was confirmed through examination under anesthesia, imaging, and laryngeal electromyography (EMG).
• Endoscopic posterior cricoid reduction was performed, leading to significant voice improvement.

Implications:

• This case highlights that posterior glottic diastasis can arise idiopathically, not solely from iatrogenic causes.
• Disordered cricoid cartilage growth during puberty is a potential etiological factor.
• Successful endoscopic management offers a viable treatment option for this rare condition.