Surgical treatment of laryngomalacia

When evaluating an infant for stridor, laryngomalacia is the most commonly encountered diagnosis. In most cases, laryngomalacia is a benign, self-limited diagnosis, and treatment is expectant. In more severe cases, the child may have respiratory distress or feeding difficulties. Significant laryngomalacia may require medical and/or surgical therapy. Supraglottoplasty is indicated if airway or feeding symptoms persist after a careful preoperative evaluation and trial of medical therapy. A conservative surgical approach with division of aryepiglottic folds or unilateral mucosal ablation will avoid the serious complication of supraglottic stenosis. The success rate of supraglottoplasty for relieving symptoms of airway distress and feeding difficulties is excellent, and tracheotomy is rarely required for airway control.