Abstract
Laryngomalacia, also known as flaccid larynx, is a common cause of stridor in the newborn. The supraglottic structures, such as the epiglottis, prolapse into the endolarynx with inspiration causing airway obstruction. This entity has recentry been reported as an acquired disorder. It can occur in patients who have lost laryngeal airway support becase of previous head and neck surgery, with progressive neurologic impairment or after head injury and coma. A case of a 47-year-old, previously healthy man presenting with a subarachnoid hemorrhage is described. Four days after a successful operation by a neurosurgeon, his severe inspiratory stridor prevented extubation. Examination with fiberoptic nasolaryngoscopy revealed subtotal airway obstruction due to epiglottis prolapse during inspiration. The patient was initially treated with NIPPV (non-invasive positive pressure ventilation), but was reintubated because of respiratory distress. Finally, he was extubated successfully after spontaneous resolution of the airway obstruction without any surgical laryngeal intervention.
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