title: Laryngomalacia. The search for the second lesion.
abstract: OBJECTIVE
  To determine the necessity of rigid endoscopy in the diagnosis and management of laryngomalacia and its associated synchronous airway lesions (SALs), to analyze the incidence of SALs associated with laryngomalacia and their significance, and to determine the need for epiglottoplasty in management of laryngomalacia.
  
  
  METHODS
  Retrospective medical chart review.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Two hundred thirty-three patients with a primary diagnosis of laryngomalacia on flexible fiberoptic laryngoscopy treated at the Children's National Medical Center, Washington, DC, from January 1, 1984, to June 30, 1994.
  
  
  METHODS
  Evaluation and treatment of laryngomalacia and associated SAL by flexible fiberoptic laryngoscopy, radiographic studies, rigid endoscopy, and other surgical procedures.
  
  
  METHODS
  Resolution of airway symptoms from laryngomalacia and associated SAL.
  
  
  RESULTS
  Ninety patients (38.6%) underwent rigid endoscopy, and 12 patients (5.2%) required epiglottoplasty. Synchronous airway lesions were discovered in 44 patients (18.9%). Eleven patients (4.7%) had SALs that wre considered clinically significant; nine (3.9%) of these required surgical intervention.
  
  
  CONCLUSIONS
  Rigid endoscopy in evaluation of an infant with laryngomalacia is rarely necessary. Clinically significant SALs requiring surgical intervention are uncommon. Surgical intervention for laryngomalacia also is rarely necessary.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, George Washington University, Washington, DC, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Mancuso
authors.forename: S S
authors.initials: SS
authors.lastname: Choi
authors.forename: G H
authors.initials: GH
authors.lastname: Zalzal
authors.forename: K M
authors.initials: KM
authors.lastname: Grundfast
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology*; D004724:Endoscopy / Q000706:statistics & numerical data; D004825:Epiglottis / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications* / Q000151:congenital / Q000175:diagnosis / Q000628:therapy*; D007828:Laryngoscopy; D007830:Larynx / Q000002:abnormalities*; D008297:Male; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome