A case of an abnormally shaped epiglottis associated with inspiratory dyspnea.

One of major functions of the epiglottis is thought to protect the lower respiratory tract, covering the glottis in phase of swallowing. It is most likely that the epiglottis might play an important role to make food channels bilaterally cooperating with hypopharyngeal structures in swallowing.On the other hand, the epiglottis should stand up forward and upward in inspiratory phase in order to let the air pass the glottis smoothly.If the epiglottis falls down backward and downward, in inspiration, dyspnea might be caused.We have recently experienced such a patient with dyspnea. The laryngeal mirror examination revealed that the epiglottis was sucked down toward the glottis in phase of inspiration. The fluorocinematography was very useful to obtain an exact diagnosis. The epiglottis was thought to be longer than a usual one we observe clinically.We succeeded in releasing the patient from dyspnea by partial resection of the epiglottis by use of laser under microlaryngoscopical procedure.In this paper, the whole clinical course was reported and the merit of laser surgery for resection of the epiglottis through the direct laryngoscope was emphasized. The result was discussed from the viewpoint of anatomy of the epiglottis.