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Management Outcome of Severe Laryngomalacia at Queen Sirikit National Institute Child Health.

Background
Outcomes of the different management in severe laryngomalacia (LM) have not been evaluated.


Objective
To identify the management practices and to evaluate the outcomes in patient with severe LM.


Material and Method
The medical records of LM at Queen Sirikit National Institute Child Health between January2007 and December 2012 were retrospectively reviewed.


Results
Severe LM 69.8% (30/43) were found in patients diagnosed with LM. Type B (complete collapse) at 46.67% were the most common finding. Decision of management were made individually based on consideration of disease severity and comorbidity. The outcomes after management were evaluated by pre- and post-symptoms score. Post-symptoms scores were statistically significant better than pre-symptom score in all management (observation p<0.001, laser supraglottoplasty p = 0.003, and tracheotomy p = 0.001).


Conclusion
Our management in severe LM include: observation, laser supraglottoplasty, and tracheostomy. The overall post-management outcome were satisfactory but the present study was limited to relatively small number of patients.