Airway obstruction: a rare complication of benign vocal fold polyps

OBJECTIVES: Benign laryngeal polyps usually present with hoarseness and dysphonia. There have been a few reported cases, however, of polyps that caused airway obstruction. Herein we present our series of obstructing laryngeal polyps. METHODS: A retrospective review was performed of all patients with benign laryngeal lesions treated by the senior author (A.M.S.S.) between 1997 and 2006. Patients who presented with airway obstruction were identified. Detailed information was recorded on the demographics, presenting signs and symptoms, and surgical procedures. Preoperative and postoperative laryngoscopies were reviewed. RESULTS: Ten patients were identified. There were 7 women and 3 men. The mean age was 49 years (range, 34 to 64 years). All had a history of vocal abuse and smoking, with a mean of 35.2 pack-years (range, 7.5 to 112.5 pack-years). All underwent microlaryngoscopy with excision of the lesions. Jet ventilation or a small endotracheal tube was used to secure the airway. The mean follow-up of 9 patients was 71.2 days (range, 25 to 208 days); 1 patient was lost to followup. An excellent airway and improved voice was achieved in all. Forty-four percent (4 of 9) had persistent dysphonia and a decreased mucosal wave after the operation. CONCLUSIONS: Benign laryngeal polyps may present with airway obstruction and thus should be included in the differential diagnosis of stridor. Endoscopic treatment can result in an excellent airway, but dysphonia may persist in some cases.