Laryngomalacia is the most common cause of stridor in neonates. Holinger found laryngomalacia in 60% of children with congenital laryngeal anomalies who presented with stridor. Most children with laryngomalacia resolve within 18 to 24 months of birth and require no specific treatment. Quality-of-life analysis has found that most caregivers were not substantially affected by providing care to the child with laryngomalacia.
However, children with severe laryngomalacia may develop marked upper airway obstruction resulting in cor pulmonale, life-threatening apneic episodes, feeding difficulties, obstructive sleep apnea, and failure to thrive. While tracheotomy has been used in complex neonates in whom laryngomalacia is associated with other anomalies or medical problems, surgical resection of supraglottic tissues -- "supraglottoplasty" -- has been the favored approach.
We describe a simple, safe, and effective method of supraglottoplasty, first used by the senior author (DET), using through-cutting sinus dissection forceps (Figure 1) to incise or resect a portion of the aryepiglottic fold.
Straight through-cutting sinus forceps and Parsons laryngoscope used for supraglottoplasty.
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Medscape J Med. 2008;10(11):269 © 2008
Cite this: Supraglottoplasty in Infants Using Sinus Instruments - Medscape - Nov 26, 2008.