Giant laryngeal polyp: an unusual indication of tracheostomy

Abstract

Benign laryngeal lesions, especially laryngeal polyps are very common and they usually only cause hoarseness andrarely develop into dyspnea.This condition is generally attributed to smoking. Cardiorespiratory failure and sudden death due tolarge laryngeal polypwas reported in the literature. The preferred treatment of large polyps is surgical excision using suspension microlaryngoscopy. We present a case of a 60-year-old man presented to the emergency with stridor and severe dyspnea. He had a 4-month history of a neglected inspiratory dyspnea and dysphonia. Fiberoptic laryngoscopy revealed a large laryngeal mass causing airway obstruction. Administration of oxygen, inhalation and intravenous administrationof corticosteroid did not relieved hissymptoms. As intubation was judged impossible, an emergency tracheostomy was performed to salvage the patient. After tracheostomy, the dyspnea ceased. Computed tomography scan showed a homogeneous regular formation of 2.5'1.5 cm obstructing the glottis and the subglottislumen. Direct laryngoscopy under general anesthesia identified a valve-like large polyp attached to the anterior wall of the subglottic region. The polyp wastotally excised with no complication. Decannulation was carried out on the second postoperative day. The masswas histologically diagnosed as normal vocal cord polyp.

Keywords

• airway obstruction
• larynx
• polyp
• surgical treatment