The effect of aryepiglottic fold release as an adjuvant step in surgery for Type I laryngomalacia

Objective: This study aims to evaluate the efficacy of unilateral aryepiglottic fold release as an adjunctive surgical step in the management of Type I laryngomalacia. Methods: This study was prospectively conducted on a sample of paediatric patients with laryngomalacia. Our patients were randomly divided into Group A (study group, n = 25), undergoing adjuvant aryepiglottic fold release (AEFR), and Group B (control group, n = 25), who did not undergo adjuvant AEFR. Demographic data, clinical features, and outcome measures were compared between groups. Results: A highly significant difference was observed in the time to resolution of postoperative stridor, with the study group demonstrating markedly earlier symptom resolution compared to the control group. Furthermore, the percentage change in oxygen saturation in both states was also significantly greater in the study group, reflecting a highly significant intergroup difference. Additionally, the incidence of perioperative respiratory adverse events (PRAEs) was significantly lower in the study group than in the control group. Conclusions: Unilateral AEFR, as an adjunctive procedure, marks a significant advancement in management of Type I laryngomalacia. It offers targeted improvement in oxygen saturation levels during both wakefulness and sleep. Furthermore, the technique has been shown to decrease the incidence of PRAEs, delivering significant clinical and operational benefits.