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A 46-year-old woman was referred by her family physician to our voice clinic because
of difficulty in breathing accompanied by dysphonia and cough, with no other marked
changes in her general condition. Laryngeal fiberoptic study showed edema in the bilateral
anterior subglottis just below the vocal folds. The edematous lesion (Figure 1, panel A: inhalation, yellow arrow) formed a glottal chink in the anterior part of
the glottis (panel B: phonation, red arrow), which prevented vocal fold adduction
for sufficient glottal closure during phonation, causing dysphonia in the form of
breathy hoarseness. The patient's blood count, coagulation study results, and serum
chemistry levels were within normal limits, and her oxygenation level was 98%. We
therefore performed additional blood testing to rule out the presence of suspected
allergic antigens (house dust, seasonal allergy), and antinuclear antibodies. The
results of the additional blood tests were all negative. The patient was 160 cm tall,
weighed 50 kg, and had a body mass index (BMI) of 19.53.
Figure 1The edematous lesion (panel A, inhalation, yellow arrow) formed a glottal chink in
the anterior glottis (panel B, phonation, red arrow) which prevented vocal fold adduction
allowing satisfactory glottal closure for phonation.
