[Laryngomalacia. Definition, diagnosis and therapy]

Laryngomalacia, a rarely mentioned clinical entity in the German literature, is reviewed in this article. The clinical picture, diagnostics and pathogenesis are presented. The prognosis is favorable. Usually the inspiratory stridor disappears after the second year of life in most of the children. However, 7-22% of those involved develop life threatening symptoms which require surgical intervention. We performed laser supraglottoplasty, the method of choice, on five children with severe laryngomalacia. Intraoperative pre and post surgical findings and the surgical procedure are documented. The abnormally enlarged cuneiform cartilages within the aryepiglottic folds were the striking morphological feature in all of our cases. Inspiratory collapse affected only these structures. After laser supraglottoplasty, all of our children were immediately free of symptoms. Because of this high success rate, which is also reflected in literature, we recommend children with severe symptoms to have early surgery, thus preventing troublesome months in expectation of a spontaneous recovery.