David E. Tunkel, MD; Karin S. Hotchkiss, MD; Stacey Ishman, MD; David Brown, MD


November 26, 2008

Case Report

A 2-month-old male child, born at term by vaginal delivery, was referred to Johns Hopkins Pediatric Otolaryngology with progressive airway obstruction and inspiratory stridor first noted at 4 days of age. At evaluation, he was a well-nourished 5-kg infant with inspiratory high-pitched stridor, marked inspiratory sternal retraction, and a normal cry. Prolonged feeding time was noted in the clinic. Fiberoptic optic laryngoscopy showed inspiratory supraglottic obstruction from constricted aryepiglottic folds and anteromedial curling of the supra-arytenoid mucosa.

He was admitted to the Johns Hopkins Children's Center with increased work of breathing. He underwent supraglottoplasty by conservative excision of a small wedge of aryepiglottic fold on each side (Figures 2a-c). He was extubated shortly after surgery and was discharged after 24 hours of monitored observation with no stridor. He continues to do well without symptoms at 22 months of age.


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