Massive hyperplasia of the arytenoid mucosa with sleep apnea and stridor. Endoscopic resection by CO2 laser

: A case is presented of a 48 year-old woman with symptoms of severe rhoncopathy and obstructive sleep apnea, followed by middle inspiratory stridor and dyspnea to any phisial effort. Redundant hyperplasia of the arytenoid mucosa was discovered during exploration, with vibration during inspiration and closure of the lumen as it goes closer to the epiglottis. Also, severe septal deviation, hypertrophy of the pharyngeal tonsil, soft palate and uvula, and macroglossia, were diagnosed. Neither CPAP/BIAP or triple anti-reflux therapy were effective, and laser endoscopic excision resolved the laryngeal obstruction. Currently the stridor has disappeared, whereas rhoncopathy is improved with low pressure CPAP. Pathogenesis of the giant hyperplasia of the arytenoid mucosa of unknown origin is discussed, as literature search revealed only three cases reported worldwide.