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Scott C. Manning, MD; Andrew F. Inglis, MD; Jason Mouzakes, MD; Jeffrey Carron, MD; Jonathan A. Perkins, DO

Arch Otolaryngol Head Neck Surg. 2005;131:340-343.

Objectives  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.

Design  Prospective case-control study.

Setting  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.

Author Affiliations: Departments of Otolaryngology, University of Washington, Seattle (Drs Manning, Inglis, and Perkins), Albany Medical College, Albany, NY (Dr Mouzakes), and University of Mississippi Medical Center, Jackson (Dr Carron).

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