title: [Transoral treatment of severe laryngomalacia. Review and presentation of a modified surgical technique].
abstract: 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.
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Philipps-Universität Marburg. j.a.werner@mailer.uni-marburg.de
authors.forename: J A
authors.initials: JA
authors.lastname: Werner
authors.forename: B M
authors.initials: BM
authors.lastname: Lippert
authors.forename: T
authors.initials: T
authors.lastname: Ankermann
mesh_terms: 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