title: Laryngeal anatomic differences in pediatric patients with severe laryngomalacia.
abstract: OBJECTIVE
  To compare the aryepiglottic (AE) length in pediatric patients who have severe laryngomalacia (SL) and are undergoing aryepiglottoplasty with the AE length of a convenience sample of control patients without laryngomalacia.
  
  
  METHODS
  Prospective case-control study.
  
  
  METHODS
  A tertiary-care pediatric hospital.
  
  
  RESULTS
  The mean AE fold length-glottic length ratio for patients with SL (0.380) was significantly lower than the mean ratio for controls (0.535) (P = .004 in 2-sample t test with unequal variance). For patients with SL, the aryepiglottoplasy procedure resulted in an average AE length increase-glottic length ratio of 0.330. Seven of the patients with SL were also diagnosed as having an underlying neurologic condition, and 18 had a diagnosis of gastroesophageal reflux disease. Two patients with SL required a tracheotomy for treatment of persistent airway obstruction.
  
  
  CONCLUSIONS
  In this series, patients with SL had lower AE fold length-glottic length ratios and more frequent occurrence of neuromuscular tone abnormalities (especially gastroesophageal reflux) than controls. These 2 findings may be related in that low intrauterine tone might contribute to anatomic underdevelopment.
authors.affiliation: Department of Otolaryngology, University of Washington, Seattle, WA 98105, USA. scott.manning@seattlechildrens.org
authors.forename: Scott C
authors.initials: SC
authors.lastname: Manning
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Inglis
authors.forename: Jason
authors.initials: J
authors.lastname: Mouzakes
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Carron
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Perkins
mesh_terms: D000402:Airway Obstruction / Q000150:complications / Q000601:surgery; D001193:Arytenoid Cartilage / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D002675:Child, Preschool; D004825:Epiglottis / Q000473:pathology* / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000150:complications; D011446:Prospective Studies; D012008:Recurrence; D014140:Tracheotomy