Bilateral laryngeal pseudoparalysis in xanthoma disseminatum treated by endoscopic laser medial arytenoidectomy

Xanthoma disseminatum is a rare non-langerhans' cell histiocytosis, charact erized by papular cutaneous eruption, possible mucosal involvement, and fre quent association with vasopressin-sensitive diabetes insipidus. Herein we report a case of xanthoma disseminatum with pharyngolaryngeal involvement. In this patient, mucosal xanthomas involving the arytenoid cartilages and t he interarytenoid area resulted in laryngeal stenosis and severe impairment of both cricoarytenoid joints' motility. Endoscopic CO2 laser medial aryte noidectomy, according to the technique described by Crumley (1993), and vap orization of interarytenoid xanthomas were successfully performed, thus ree stablishing bilateral cordal motility and the laryngeal airway. Four years later, a CO2 laser revision was necessary because of recurrence of xanthoma s in the posterior larynx. Two years after the latter operation, the patien t has no signs of laryngeal obstruction and has a normal voice quality. Thi s case report suggests that endoscopic medial arytenoidectomy may be succes sfully used in the treatment of bilateral laryngeal pseudoparalysis seconda ry to xanthoma disseminatum.