Subtotal arytenoidectomy for the treatment of laryngeal stridor in multiple system atrophy: Phonatory and swallowing results [Aritenoidectomia subtotal para o tratamento de estridor laríngeo na atrofia de múltiplos sistemas: resultados na fonação e deglutição]

Multiple system atrophy (MSA), according to second consensus on MSA, is a neurological disorder characterized by a combination of autonomic failure and parkinsonism, or cerebellar ataxia, or both.1 Among MSA manifestations, diurnal and nocturnal inspiratory stridor associated with sleep apnoea may help in clinical diagnosis, and its most accepted explanation is vocal folds abductor dysfunction. A possible complication of this situation is sudden nocturnal death. As described in the literature, the use of C-PAP and tracheotomy are the most common treatment proposed for the therapy of the laryngeal disfunction.2 Alternatively laterofixation of the vocal fold according to Ejnell3 or laser arytenoidectomy have been proposed. Here we present the case of nocturnal inspiratory stridor in a MSA patient treated with CO2 laser subtotal aritenoidectomy, with particular attention on phonatory and swallowing outcome.