Does surgery affect the neurodevelopmental outcome of moderate laryngomalacia?

Abstract

BackgroundModerate laryngomalacia lies in the grey zone where the parents and treating team might hesitate to decide the treatment plan for the child. Neurodevelopmental assessment of the child was neither assessed nor incorporated in surgical decision-making in the past. ObjectivesTo evaluate the neurodevelopmental outcome of moderate laryngomalacia treatment strategies (surgery versus conservative). MethodsWe conducted an observational multicentric cohort study. We compared two groups of patients according to their moderate laryngomalacia treatment strategy: surgical treatment and no treatment. The neurodevelopmental outcome was assessed by Griffiths-III developmental scales. ResultsA total of 150 children were diagnosed with moderate laryngomalacia of which 56 were successfully treated with surgery and 94 improved without intervention. The median Griffiths-III developmental quotients (DQs) of subscales A, B, C, E, and general development were significantly higher in the surgically treated group compared to conservatively treated ones. ConclusionUntreated moderate laryngomalacia cases have worse neurodevelopmental outcomes than surgically treated cases.