[Severe laryngomalacia: surgical indications and results in 33 patients].
BACKGROUND
Laryngomalacia is the most common course of stridor in children: with a 50% to 75% incidence. About 50% to 60% of congenital laryngeal anomalies that present with stridor are due to laryngomalacia. In most cases, the disease followed a benign course but the prognosis is less favorable in 10% to 15% of cases. These patients may require surgical intervention.


METHODS
This prospective study included 33 patients referred to our institution from May 1998 to May 2003 for severe laryngomalacia. The diagnosis of severe laryngomalacia was based on clinical and if necessary paraclinical data. An endoscopic laser resection of arytenoid mucosal excess associated if necessary with suprahyoid epiglottectomy was performed in all patients.


RESULTS
Mean age of the children was 7.5 Months (range, 2 weeks-4 Years). Ninety-six percent of the patients had complete resolution of symptoms before the fourth postoperative week. Ninety one percents of the patients had effective oral feeding within the first Month (48% immediately after surgery). The average hospital stay was 6 days (range, 3 to 14). Weight gains were found to be satisfactory in all cases since children were discharged the hospital.


CONCLUSIONS
Endoscopic laryngeal surgery is an appropriate therapy for treatment of severe forms of laryngomalacia. It is a safe and effective surgical procedure.
Merrot
O
O
Service ORL et CCF, CHRU Claude Huriez, Place Polonovski, 59037 Lille Cedex.
Fayoux
P
P
Vachin
F
F
Chevalier
D
D
Desaulty
A
A
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index