What surgical procedure is indicated for severe symptoms of laryngomalacia that do not resolve by 18 months?

In cases of severe laryngomalacia where symptoms persist despite conservative management and do not resolve by 18 months of age, supraglottoplasty is the surgical procedure of choice. Laryngomalacia is characterized by the abnormal flapping of tissues above the vocal cords, leading to airway obstruction and respiratory distress. Supraglottoplasty involves the surgical modification or removal of the redundant tissue causing the obstruction. This procedure effectively alleviates the symptoms associated with laryngomalacia, such as stridor, respiratory distress, and feeding difficulties.

This is particularly relevant for children whose quality of life is significantly affected by their condition. Supraglottoplasty aims to improve airway patency and facilitate normal respiratory function, which can greatly enhance the child's overall health and development.

Other surgical options, such as tracheostomy, may provide short-term relief in severe cases, but they involve more significant risks and complications and do not address the underlying issue of laryngomalacia. Endotracheal intubation is generally reserved for acute situations requiring immediate airway management rather than a definitive solution for laryngomalacia. Vocal cord injection is not appropriate for this condition, as it targets different airway pathologies, typically involving vocal cord paralysis rather than malformation like