Laryngomalacia causing sleep apnea in an osteogenesis imperfecta patient.

Obstructive sleep apnea is rarely caused by laryngomalacia in adult patients. To our knowledge, laryngomalacia secondary to osteogenesis imperfecta inducing obstructive sleep apnea has not been reported. We present an adult osteogenesis imperfecta patient with obstructive sleep apnea. Oral examination demonstrated an extremely long epiglottis in the oral cavity. Fiberoptic nasopharyngoscopy revealed that the epiglottis and redundant mucosa of the arytenoids were drawn into the laryngeal inlet during inspiration. Supraglottoplasty with intraoral and laryngoscopic approach was carried out and resulted in marked decreases in snoring, sleep apnea, and daytime sleepiness. In this report, we describe a unique laryngeal manifestation inducing obstructive sleep apnea in an adult with brittle bone disease. The anomaly of laryngeal structure can be corrected by surgical intervention with good response in the sleep-disordered breathing.