title: Medical and surgical management of congenital laryngomalacia: a case-control study.
abstract: OBJECTIVE
  To compare the growth of infants with moderate to severe laryngomalacia who underwent supraglottoplasty to the growth of those treated with medical therapy alone.
  
  
  METHODS
  Case-control study of patients treated between 2008 and 2013.
  
  
  METHODS
  Tertiary care pediatric otolaryngology practice.
  
  
  METHODS
  Fifty-one infants newly diagnosed with moderate to severe congenital laryngomalacia. Seventeen infants underwent supraglottoplasty and 34 matched controls had medical management, which included acid suppression therapy, speech and swallowing therapy, and/or high-calorie formula. The primary outcome measure was weight percentile recorded at the second clinic visit and at the last available follow-up. The secondary outcomes were the need for primary or revision supraglottoplasty, tracheostomy or gastrostromy, or the development of or persistence of failure to thrive.
  
  
  RESULTS
  There was no difference in the mean weight percentile between the surgical and nonsurgical groups at the time of last follow-up (P = .89). The mean change in weight percentile during the study period was 32% (95% CI, 15%-48%) in the supraglottoplasty group and 31% (95% CI, 22%-40%) in the medical group (P = .97). Five of 5 (100%) patients with failure to thrive managed surgically and 10 of 10 (100%) managed medically were above the fifth percentile at the end of the follow-up period. One (3%) patient in the medical management group required tracheostomy and gastrostomy tube placement.
  
  
  CONCLUSIONS
  Medical management and close observation of infants with moderate to severe congenital laryngomalacia may be a viable alternative to supraglottoplasty in appropriately selected infants.
authors: Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA.
authors: John
authors: J
authors: Faria
authors: Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA pmbehar1@gmail.com.
authors: Philomena
authors: P
authors: Behar
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D055092:Laryngomalacia / Q000151:congenital* / Q000601:surgery / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014139:Tracheostomy
keywords: congenital stridor; laryngomalacia; stridor; supraglottoplasty; weight gain