Association Between Acid Reflux Medication and Supraglottoplasty in Infant Laryngomalacia

Area of Science:

• Pediatric Otolaryngology
• Gastroenterology
• Neonatal Medicine

Background:

• Acid suppression therapy is commonly used for infant laryngomalacia, despite limited evidence of its effectiveness.
• Laryngomalacia, a condition causing stridor in infants, is often managed with medications for gastroesophageal reflux disease (GERD).
• The efficacy of GERD medications in treating laryngomalacia symptoms remains under investigation.

Purpose of the Study:

• To determine the frequency of supraglottoplasty in infants diagnosed with nonsevere laryngomalacia.
• To compare supraglottoplasty rates between infants treated with GERD medications and those managed with watchful waiting.
• To evaluate the impact of GERD medication on the need for surgical intervention in nonsevere laryngomalacia.

Main Methods:

• Retrospective cohort study of 395 infants under 6 months with nonsevere laryngomalacia.
• Patients were divided into two groups: observation alone versus trial of GERD medications.
• Data collected from 2014-2023 at a pediatric otolaryngology clinic.

Main Results:

• The overall supraglottoplasty rate was 4.1% (16/395).
• Rates of supraglottoplasty were similar between the observation (3.4%) and GERD medication (6.7%) groups.
• The observed difference in surgical rates between groups was not statistically significant due to estimate imprecision.

Conclusions:

• Management of nonsevere laryngomalacia with GERD medications resulted in similar supraglottoplasty rates compared to watchful waiting.
• Female sex and laryngomalacia severity (based on endoscopy) were identified as key predictors for requiring supraglottoplasty.
• Further research is needed to definitively conclude the role of GERD medications in nonsevere laryngomalacia management.