Clinical Relevance of Quality of Life in Laryngomalacia

Objectives/Hypothesis: To examine aspects of laryngomalacia and correlate findings with quality of life (QOL). Study Design: Prospective cross-sectional study. Methods: Seventy-two patients with laryngomalacia were examined; the mean age was 8.8 weeks. Parents answered questions from the Infant and Toddler Quality of Life Questionnaire-47 (ITQOL-SF47). Fiberoptic laryngoscopy and endoscopic examination of swallowing (FEES) were performed. The presence of laryngomalacia-associated characteristics and swallowing status were recorded. Patient age, sex, presence of reflux, clinical severity, anatomical findings, and swallowing results were evaluated through logistic regression. Independent sample t tests were used to compare responses on the ITQOL-SF47. Overall laryngomalacia ITQOL-SF47 scores were compared to the scores of a large healthy sample population. Results: Forty-three (60%) patients had mild laryngomalacia, and 61 (85%) patients had findings suggesting gastroesophageal reflux disease. The most common abnormality was shortened aryepiglottic folds. Ten patients failed FEES. Patients with moderate laryngomalacia (=7.62; P=.006) or prolapsing cuneiforms (=4.79; P=.029) were more likely to fail FEES. Laryngomalacia severity impacted parental perception of their child's health (P<.05). Parents of children who demonstrated aspiration or penetration reported significant emotional impact (mean=56.9; t=2.74; P=.008). The mean ITQOL-SF47 scores of patients were significantly lower in certain sections than the reported general sample population. Conclusions: Epiglottal prolapse correlated with severity of laryngomalacia and cuneiform prolapse with swallowing dysfunction. Perceptions of worsening health and physical ability were related to severity of disease. Swallowing dysfunction had a significant emotional impact on parental daily life. Infants with laryngomalacia have a lower QOL