Congenital absence of the epiglottis and its potential role in obstructive sleep apnea.

A 3 month old girl with congenital absence of the epiglottis presents with inspiratory stridor. Over the next 8 years frank obstructive sleep apnea (OSA) develops, confirmed by polysomnography. She has no difficulty in swallowing or phonation as assessed clinically and with barium swallow. This suggests that the epiglottis may help stabilize the upper airway, and any role in swallowing or phonation may, in its absence, be compensated by other mechanisms.