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ENT · Larynx and airway: supraglottoplasty for severe laryngomalacia
Sample itemA 4-month-old with inspiratory stridor has apnoeic episodes and poor weight gain. Laryngoscopy shows prolapse of arytenoid mucosa and a short aryepiglottic fold. Which intervention is indicated?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Endoscopic supraglottoplasty
Most laryngomalacia is mild and resolves, but severe cases with apnoea, cyanosis or failure to thrive are treated by supraglottoplasty, trimming redundant supraglottic tissue. Tracheostomy is a last resort.
Option by option
A. Tracheostomy in all cases
Tracheostomy is a rescue and not first-line.
B. Long-term oral steroids
Steroids do not alter the anatomy.
C. Observation without intervention
Observation alone is for mild cases without complications.
D. Endoscopic supraglottoplasty (correct)
Correct. Severe laryngomalacia with apnoea and poor growth warrants endoscopic supraglottoplasty.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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