Novel Treatment of Laryngomalacia: A Case Series

Main Article Content

Tazeen Fatima
Muhammad Amjad Hussain
Muhammad Sajid
Hadeeba Arfan
Amna Awan
Maria Arif


Background: Laryngomalacia is a prevalent neonatal condition characterized by the increased pliability of laryngeal tissues, leading to airway obstruction and associated respiratory complications. It necessitates a nuanced approach to diagnosis and management, given its variable clinical presentation and potential for significant morbidity.

Objective: This study aims to investigate the clinical presentation, management, and outcomes of neonates with laryngomalacia, focusing on the efficacy of individualized treatment approaches including bronchoscopy, laser ablation, and various ventilation strategies.

Methods: This retrospective case series analyzed data from two neonates treated for laryngomalacia at Children Center Hospital Tehran between 2021 and 2022. Inclusion criteria were neonates beyond 28 weeks gestation without congenital abnormalities and with an RDS score ≥8. Exclusion criteria included preterm neonates (<28 weeks), an RDS score <8, and congenital abnormalities. Data collection involved measures such as respiratory assistance, stridor, feeding issues, oxygen requirement, hospital stay duration, ventilation days, gestational age, RDS score, retraction severity, and amniotic blood gas values. Ethical considerations were observed throughout the study.

Results: The first neonate, a 29-day-old female with a gestational age of 36 weeks and 5 days, required HFNC and laser ablation, leading to the resolution of stridor and feeding difficulties. Her hospital stay was 46 days. The second neonate, a 16-day-old male born at 38 weeks gestation, experienced complications including VAP and required a more extended treatment course, including intubation, NIV, CPAP, and HFNC, culminating in an 80-day hospital stay.

Conclusion: The study highlights the importance of personalized and adaptable treatment strategies in managing laryngomalacia in neonates. The variability in clinical presentations and responses to treatment underscores the need for ongoing research and the development of refined management protocols. A multidisciplinary approach, incorporating timely diagnosis and flexible intervention, is crucial for optimal patient outcomes.

Article Details

How to Cite
Fatima, T., Hussain, M. A., Sajid, M., Arfan, H., Awan, A., & Arif, M. (2024). Novel Treatment of Laryngomalacia: A Case Series. Journal of Health and Rehabilitation Research, 4(1), 49–53.


Hsu AK, Rosow DE, Wallerstein RJ, April MM. Familial congenital bilateral vocal fold paralysis: a novel gene translocation. International journal of pediatric otorhinolaryngology. 2015;79(3):323-7.

Sandu K, Monnier P, Reinhard A, Gorostidi F. Endoscopic epiglottopexy using Lichtenberger's needle carrier to avoid breakdown of repair. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2015;272(11):3385-90.

Ching HH, Spinner AG, Reeve NH, TJ OL. A novel technique for unilateral supraglottoplasty. International journal of pediatric otorhinolaryngology. 2018;104:150-4.

Pu S, Xu H, Li X. Supraglottoplasty in neonates and infants: A radiofrequency ablation approach. Medicine. 2018;97(7):e9850.

Álvarez-Neri H, Villamor P, Ortiz Hernandez E, Penchyna Grub J. Epiglottopexy by external puncture for epiglottic prolapse in severe laryngomalacia. A novel technique. European annals of otorhinolaryngology, head and neck diseases. 2019;136(2):115-7.

AbdelFattah ElSobki A, Hashish MI, El-Kholy NA. One and half coblation supraglottoplasty: A novel technique for management of type II laryngomalacia. International journal of pediatric otorhinolaryngology. 2020;138:110330.

Lau CL, Chee YY, Chung BHY, Wong MSR. CHARGE syndrome patient with novel CHD7 mutation presenting with severe laryngomalacia and feeding difficulty. BMJ case reports. 2020;13(7).

Lawlor C, Smithers CJ, Hamilton T, Baird C, Rahbar R, Choi S, et al. Innovative management of severe tracheobronchomalacia using anterior and posterior tracheobronchopexy. The Laryngoscope. 2020;130(2):E65-e74.

Soong WJ, Yang CF, Lee YS, Tsao PJ, Lin CH, Chen CH. Vallecular cyst with coexisting laryngomalacia: Successful diagnosis and laser therapy by flexible endoscopy with a novel noninvasive ventilation support in infants. Pediatric pulmonology. 2020;55(7):1750-6.

Kamran A, Smithers CJ, Baird CW, Jennings RW. Experience with bioresorbable splints for treatment of airway collapse in a pediatric population. JTCVS techniques. 2021;8:160-9.

Panda PK, Tomar A, Pillai GR, Kumar A, Sharawat IK. Infantile tremor syndrome and laryngomalacia: A novel association? Clinical nutrition ESPEN. 2021;43:235-8.

Ng SW, Syafina H, Goh LC. Dual Staged Supraglottoplasty for the Treatment of Trapdoor Epiglottis with Underlying Neurodegenerative Disease-Case report and Review of literature. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India. 2022;74(Suppl 3):5033-6.

Song JS, Sloychuk J, El-Hakim H, Isaac A. A novel sleep oximetry scoring tool for pediatric laryngomalacia. International journal of pediatric otorhinolaryngology. 2022;160:111220.

Schuberth K, Ramani PK, Beemarajan E, Veerapandiyan A. Child Neurology: KMT2B-Related Dystonia in a Young Child With Worsening Gait Abnormality. Neurology. 2023;101(7):328-32.

Mathur N, Verma RK, Jaitly S, Kumar A. Atypical Presentation of Severe Laryngomalacia Managed with Aryepiglottoplasty and A Novel Suture Technique.

Chen JL, Messner AH, Chang KW. Familial laryngomalacia in two siblings with syndromic features. International journal of pediatric otorhinolaryngology. 2006;70(9):1651-5.

Manickavasagam J, Jebreel Ae. Novel Suction holder clips for endolaryngeal laser surgery. Otolaryngology–Head and Neck Surgery. 2012;147(S2):P194-P5.

Erickson B, Cooper T, El-Hakim H. Factors associated with the morphological type of laryngomalacia and prognostic value for surgical outcomes. JAMA Otolaryngology–Head & Neck Surgery. 2014;140(10):927-33.

Mase CA, Chen ML, Horn DL, Parikh SR. Supraglottoplasty for sleep endoscopy diagnosed sleep dependent laryngomalacia. International journal of pediatric otorhinolaryngology. 2015;79(4):511-5.

Pu S, Xu H, Li X. Supraglottoplasty in neonates and infants: a radiofrequency ablation approach. Medicine. 2018;97(7).

Scott BL, Lam D, MacArthur C. Laryngomalacia and swallow dysfunction. Ear, Nose & Throat Journal. 2019;98(10):613-6.

Panda PK, Tomar A, Pillai GR, Kumar A, Sharawat IK. Infantile tremor syndrome and laryngomalacia: A novel association? Clinical nutrition ESPEN. 2021;43:235-8.

Teague WG, Lawrence MG, Williams S, Garrod AS, Froh D, Early SV, et al. Novel treatment-refractory preschool wheeze phenotypes identified by cluster analysis of lung lavage constituents. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9(7):2792-801. e4.

Powell AR, Srinivasan S, Helman JL, Li AD-R, O’Brien LM, Shih A, et al. Novel treatment for hypotonic airway obstruction and severe obstructive sleep apnea using a nasopharyngeal airway device with 3D printing innovation. Journal of Clinical Sleep Medicine. 2022;18(10):2497-502.

Shivnani D, Raman E, Kurien M, Ram G, Amle D. Surgical Candidacy for Management of Laryngomalacia: A Proposed Scoring System. Indian Journal of Otolaryngology and Head & Neck Surgery. 2023;75(1):151-8.

Most read articles by the same author(s)