[Transoral treatment of severe laryngomalacia. Review and presentation of a modified surgical technique].
BACKGROUND
Laryngomalacia is the most common cause of stridor in children. So far various authors have described surgical techniques in a sense of a supraglottoplasty or an epiglottoplasty to handle the severe form of this disease. We present a modified technique of the so called epiglottopexy.


METHODS
Under the different types of laryngomalacia this study focuses on the treatment of three patients (5 to 10 months) with a posterior displacement of the epiglottis during inspiration. The first step of our technique was to denude a small portion of the base of the tongue from mucosa. A corresponding lesion was created on the lingual surface of the epiglottis. The vaporisation of the mucosa was performed with the CO2 laser at a power setting of 1 Watt and a 0.25 mm spot size. The epiglottis was then fixed transorally to the base of the tongue with 2 single stitch sutures and 1 inverse mattress suture, using a resorbable material.


RESULTS
No intra- or postoperative complications were observed. All three patients demonstrated a significant airway improvement without stridor.


CONCLUSIONS
The presented technique of transoral laser surgical epiglottopexy seems to be a method suitable for the treatment of laryngomalacia caused by posterior displacement of the epiglottis.
Werner
J A
JA
Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Philipps-Universität Marburg. j.a.werner@mailer.uni-marburg.de
Lippert
B M
BM
Ankermann
T
T
D000367:Age Factors; D004825:Epiglottis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000601:surgery*; D007828:Laryngoscopy; D053685:Laser Therapy; D008297:Male