A Case Report: Supraglottic Membrane

Introduction: Laryngeal membranes are uncommon abnormalities, characterized by the presence at birth of membranous tissue in the supraglottic, glottic, and subglottic region. They account for about 5% of the malformations of the larynx and can cause airway obstruction leading to stridor and respiratory dysfunction. Affected individuals often have associated anomalies, such as congenital heart defects, often known as genetic syndromes.

Objectives: The aim of this study is to report a case of supraglottic membrane.

Case report: A neonate (R.N.) aged 12 days, showing biphasic stridor since birth, worse during breast-feeding, and progressing to cyanosis, SaO₂ 89%, in genetic research for heart failure. R.N. in tracheal intubation was requested for ENT evaluation. Laryngoscopy of R.N. shows supraglottic membrane blocking 85% of the lumen. R.N. was held for laryngeal microsurgery using diode laser. R.N. resulted in the complete improvement of symptoms and was extubated 48 hours after the surgery. After 10 days, new laryngoscopy showed no lumen obstruction and arytenoid edema. R.N. was diagnosed with Down syndrome.

Conclusion: All stridor should be investigated and should not be considered benign until its cause is unclear. Congenital malformations of the larynx are entities in which early diagnosis is critical. Proper and early ENT evaluation by endoscopic laryngoscopy is necessary for the elucidation and proper conduct of the cases. The laser diode displayed less aggression leading to less edema to the underlying tissues, and proved to be an excellent and effective therapeutic option for early treatment. We conclude that the presence of laryngeal stridor should always be investigated.