Large laryngeal polyp causing airway obstruction

A 62-year-old woman smoker presented with 1 week of common cold and worsening hoarseness. She presented with dyspnea, which had been worsening over the past few days. On the initial examination in theemergency room, she couldnot liedown, stridor was evident and fiberoptic laryngoscopy revealed large laryngeal mass causing airway obstruction. Large laryngeal mass disappeared in subglottis with inspiration (Fig. 1a) and appeared in supraglottis with expiration (Fig. 1b). She had a normal white cell count (7.5 × 10/μl; normal 4.0−9.0 × 10/μl) and a raised C-reactive protein (0.55 mg/dl; normal 0.00–0.30 mg/dl). Because intubation was judged impossible, an emergency tracheotomywas performed under local anesthesia. Subsequent direct laryngoscopy under general anesthesia identified avalve-like large laryngealmass attached to the right vocal cord. I removed it byapair ofmicroscissors. Pathological diagnosis was laryngeal polyp. The patient recovered well andwas discharged after 2 weeks. Although she had no recurrence andwas uneventful during the 1-year follow-up, I have been telling her strongly not to smoke. Laryngeal polyps are among the most common lesions of the vocal cords and are generally benign, both histologically and in their clinical behavior. Although their usual presenting symptom is hoarseness, acute airway obstruction from laryngeal polyps is