Abstract

Controversy exists as to the preferred treatment modality for managing refractory pediatric laryngomalacia (LM). Simultaneous bilateral procedures have been associated with supraglottic stenosis. Unilateral operations have a higher rate of secondary intervention. This prospective study was conceptualized to ascertain a preferred approach. A secondary goal was to correlate the surgical outcome with presenting symptoms and signs. Twenty-two children with severe LM met the criteria for enrollment. Bilateral CO(2) laser-assisted supraglottic laryngoplasties were performed in all cases. The procedure mainly consisted of division of the aryepiglottic fold. Nineteen (86%) patients met our defined success criteria. There were no surgical complications. Bilateral supraglottic laryngoplasty has a role in the management of severe refractory LM.

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