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Unusual Laryngeal Problems in Children

Three rare laryngeal lesions were seen in one year at Children's Hospital Medical Center in Boston. Case 1 is a subglottic mass that is a diagnostic problem since various pathologists have differing opinions ranging from a benign to a malignant tumor. The tumor mass was totally removed as a biopsy and to avoid a tracheotomy. Clinical management is now conservative and awaits both a definite pathologic diagnosis as well as a definite clinical course. Case 2 is an isolated lymphangioma of the larynx unrelated to a cervical cystic hygroma. The edematous arytenoid prominences and aryepiglottic folds were removed with an excellent functional result. Case 3 is a bilateral vocal cord adhesion following four days of endotracheal intubation. An inappropriate diagnosis of bilateral vocal cord abductor paralysis was made earlier and corrected on a later microscopic examination of the larynx. Simple division of the posterior adhesion gave an excellent functional result. Suspension laryngoscopy with microscopic examination of the larynx was important in all three cases both from a diagnostic and a therapeutic viewpoint.