Laser supraglottoplasty for laryngomalacia: are specific anatomical defects more influential than associated anomalies on outcome?

Objective: To evaluate different CO2 laser procedures on children with various types of laryngomalacia and determine the role of associated anomalies on the outcome. Design: Retrospective chart review. Setting: Academic tertiary referral center. Patients: Twenty-three children who underwent laser supraglottoplasty for laryngomalacia between 1991 and 1998 at the UC Davis Medical Center. Interventions: CO2 laser vaporization of redundant supraglottic mucosa of the aryepiglottic fold, arytenoid, and the epiglottis, or modification of the latter, either individually or in combination, based on the obstructing anatomy. Outcome measures: Immediate, short term, intermediate and long term relief of respiratory symptoms, feeding difficulties, effect of associated anomalies on outcome, effect of specific anatomic obstructing site and surgical procedure performed on outcome, and the incidence of complications inherent to the procedure. Results: Children without associated anomalies invariably did very well, with 78% immediately resolving their respiratory symptoms and 100% within a week. Twelve of the 14 patients with unfavorable immediate results (P