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Heterotopic Epiglottic Lymphoid Tissue (HELT) Causing Recurrent Epiglottitis

C Michael Haben and Dating Liu

Problem: A unique case of recurrent infectious epiglottitis in an immunocompetent, fully immunized, non-syndromic 23 year old female.

Method: Case report

Results: Patient was successfully managed with an endoscopic partial epiglottectomy at two years of follow-up. Pathology revealed what appears to be sub-mucosal germinally-active heterotropic lymphoid tissue within the epiglottic soft tissues as the likely cause of the recurrent epiglottitis.

Conclusions: The embryology of the lingual tonsils and epiglottis may provide a clue to the etiology of this case. Heterotrophic epiglottic lymphoid tissue may be considered a newly described, clinically significant congenital laryngeal anomaly that may not present until adulthood and should be considered in rare cases of recurrent infectious epiglottitis.