Upper respiratory inflammation as a potential contributor to acquired laryngomalacia: A case report and surgical perspective

Acquired laryngomalacia (LM) is a rare condition characterized by prolapse of supraglottic structures during inspiration, often associated with neurological abnormalities. We report a unique case of acquired LM in a 13-year-old boy with no neurological issues, following symptoms of upper respiratory inflammation (URI). The patient presented with persistent stridor and dyspnea that were unresponsive to two months of conservative treatment, significantly affecting his quality of life. Flexible laryngoscopy revealed prolapse of the bilateral arytenoid mucosa, which worsened during deep inspiration. Two-stage supraglottoplasty was performed, with complete resolution of symptoms and no recurrence over two years. We hypothesize that inflammation and edema induced by URI contributed to the development of acquired LM, a mechanism not previously reported. This case highlights the importance of considering URI as a trigger, emphasizes the need to investigate inflammatory mechanisms underlying acquired LM, and demonstrates the efficacy of tailored surgical approaches for this rare condition.