High-Rising Epiglottis in Children: Should It

High-Rising Epiglottis in Children: Should It Cause Concern?
Posted 11/01/2007
Nadeem Petkar, MBBS, MS; Christos Georgalas, MBBS; Abir Bhattacharyya, MBBS, MSAuthor Information
Overview and Introduction
Overview
An omega-shaped epiglottis is frequently associated with laryngomalacia. However, an elongated high-rising epiglottis can represent a normal variation of the larynx in a majority of pediatric patients. It is important to consider this in a healthy child with no complaints apart from the sensation of a foreign body in throat. This will avoid triggering any unnecessary investigation or treatment. An elongated epiglottis projecting in the oropharynx can appear as a foreign body and be a source of anxiety for the parents as well as the unaware family practitioner. We present such a case, with a brief discussion of the pediatric larynx and the omega-shaped epiglottis.
Introduction
A 3-year-old girl was brought by her mother to the otolaryngology rapid access clinic. The girl had been complaining of an intermittent foreign body sensation in her throat. Her mother and the patient herself described a "googly" in the back of her throat when she popped her tongue out. There was no associated history of stridor, shortness of breath, or symptoms suggestive of a sleep apnea. There was no history of reflux disease or odynophagia.
During examination of the oral cavity, an anterior larynx was noted and an elongated high-rising epiglottis was clearly visible in the oropharynx (Figure 1). The tonsils were not inflamed and nasal examination was unremarkable. The extremely high-rising epiglottis was diagnosed as the cause of the foreign body sensation felt by the child. The child was not in respiratory distress and was maintaining good oxygen saturation on air. Both mother and child were reassured as to the benign nature of this condition and discharged.