Laryngeal anatomic differences in pediatric patients with severe laryngomalacia.
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.
Manning
Scott C
SC
Department of Otolaryngology, University of Washington, Seattle, WA 98105, USA. scott.manning@seattlechildrens.org
Inglis
Andrew F
AF
Mouzakes
Jason
J
Carron
Jeffrey
J
Perkins
Jonathan A
JA
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