In most cases of laryngomalacia, therapy is

• A. Epiglottoplasty
• B. Observation and reassurance
• C. Tracheostomy
• D. Laryngoplasty

Answer: (B)

Most laryngomalacia cases are mild and self-limiting. The floppy supraglottic tissues that cause the airway narrowing tend to improve as the infant grows, so symptoms like inspiratory stridor usually lessen and disappear by about 12 to 18 months. Because of this natural course, the typical management is observation and reassurance, with regular follow-up to ensure feeding and weight gain are adequate and to watch for any signs that the condition is more severe. Interventions are reserved for warning signs such as poor weight gain, recurrent apnea or cyanosis, or significant respiratory distress. In those rare situations, surgical options like supraglottoplasty (epiglottoplasty) can be considered to reduce the airway obstruction, and tracheostomy is only for the most severe, uncontrolled cases. Laryngoplasty isn’t the standard treatment for the usual presentation.