{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:27:49Z","timestamp":1775816869271,"version":"3.50.1"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec id=\"ab-ooi250022-4\"><jats:title>Importance<\/jats:title><jats:p>Acid suppression therapy is frequently administered to infants with laryngomalacia presenting with stridor despite limited evidence in the literature reporting its efficacy for this subset of patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi250022-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the frequency of supraglottoplasty in infants with nonsevere laryngomalacia treated with gastroesophageal reflux disease (GERD) medications.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi250022-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study included infants younger than 6 months with a clinical diagnosis of nonsevere laryngomalacia initially managed with either watchful waiting or GERD medications. Patients were recruited from 2014 to 2023 to a pediatric otolaryngology airway clinic at a tertiary care pediatric hospital.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi250022-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the frequency of supraglottoplasty following nonsurgical management. Patients with nonsevere laryngomalacia were divided into 2 groups based on whether their laryngomalacia was managed with GERD medication therapy or observation alone. The aim was to assess the difference in supraglottoplasty rates between these 2 groups.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi250022-8\"><jats:title>Results<\/jats:title><jats:p>The medical records of 395 infants younger than 6 months (171 female, 224 male) with nonsevere laryngomalacia managed with observation after their initial otolaryngology evaluation were analyzed: observation (n\u2009=\u2009320) and trial of GERD medications (n\u2009=\u200975). Baseline characteristics between the observation and GERD medication groups were similar. The overall supraglottoplasty rate was 4.1% (16\/395), with a small increase in the use of surgical treatment between the observation and GERD medication cohorts (3.4% vs 6.7%; difference, \u22123.2% [95% CI, \u221210% to 3.6%]). The imprecision in the estimate prevents making a definitive conclusion regarding the observed difference.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi250022-9\"><jats:title>Conclusions<\/jats:title><jats:p>This study found that rates of supraglottoplasty in infants with nonsevere laryngomalacia with GERD managed with GERD medications were similar to those without reflux managed with watchful waiting. Female sex and severity of laryngomalacia based on endoscopic examination were the best predictors of receipt of supraglottoplasty after a period of watchful waiting.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2025.1201","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T11:30:46Z","timestamp":1748518246000},"page":"693","source":"Crossref","is-referenced-by-count":4,"title":["Association Between Acid Reflux Medication and Supraglottoplasty in Infant Laryngomalacia"],"prefix":"10.1001","volume":"151","author":[{"given":"Habib","family":"Zalzal","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Children\u2019s National Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisha","family":"Pershad","sequence":"additional","affiliation":[{"name":"School of Medicine & Health Sciences, George Washington University, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hengameh","family":"Behzadpour","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Children\u2019s National Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md Sohel","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of General and Thoracic Surgery, Children\u2019s National Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Zalzal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Children\u2019s National Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"5","key":"ooi250022r1","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1177\/000348940711600503","article-title":"Etiology of stridor in infants.","volume":"116","author":"Zoumalan","year":"2007","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"1","key":"ooi250022r2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/S0165-5876(97)00151-1","article-title":"Gastroesophageal reflux association with laryngomalacia: a prospective study.","volume":"43","author":"Giannoni","year":"1998","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"1","key":"ooi250022r3","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1001\/archoto.2007.17","article-title":"Late-onset laryngomalacia: a variant of disease.","volume":"134","author":"Richter","year":"2008","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"ooi250022r4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2024.111896","article-title":"Characteristics and outcomes of interventions for pediatric laryngomalacia: a systematic review with meta-analysis.","volume":"178","author":"Mills","year":"2024","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ooi250022r5","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.ijporl.2016.04.007","article-title":"International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations.","volume":"86","author":"Carter","year":"2016","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"2","key":"ooi250022r6","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1378\/chest.119.2.409","article-title":"The prevalence of gastroesophageal reflux in infants with tracheomalacia and laryngomalacia.","volume":"119","author":"Bibi","year":"2001","journal-title":"Chest"},{"issue":"6","key":"ooi250022r7","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1097\/MOO.0b013e3283405e48","article-title":"Laryngomalacia: factors that influence disease severity and outcomes of management.","volume":"18","author":"Thompson","year":"2010","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"ooi250022r8","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/753526","article-title":"Laryngomalacia: disease presentation, spectrum, and management.","volume":"2012","author":"Landry","year":"2012","journal-title":"Int J Pediatr"},{"issue":"11","key":"ooi250022r9","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1001\/archotol.129.11.1213","article-title":"Extraesophageal reflux in pediatric patients with upper respiratory symptoms.","volume":"129","author":"Rosbe","year":"2003","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"4","key":"ooi250022r10","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1177\/0194599812452833","article-title":"A systematic review of laryngomalacia and acid reflux.","volume":"147","author":"Hartl","year":"2012","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"ooi250022r11","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.pcl.2021.12.003","article-title":"Stridor in the infant patient.","volume":"69","author":"Zalzal","year":"2022","journal-title":"Pediatr Clin North Am"},{"issue":"3","key":"ooi250022r12","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1097\/MPG.0000000000001889","article-title":"Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.","volume":"66","author":"Rosen","year":"2018","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"ooi250022r13","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.jpeds.2021.06.051","article-title":"Acid suppression does not improve laryngomalacia outcomes but treatment for oropharyngeal dysphagia might be protective.","volume":"238","author":"Duncan","year":"2021","journal-title":"J Pediatr"},{"issue":"1 Pt 1","key":"ooi250022r14","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1177\/000348948709600118","article-title":"Epiglottoplasty for the treatment of laryngomalacia.","volume":"96","author":"Zalzal","year":"1987","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"3","key":"ooi250022r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2022.103434","article-title":"Initiation of acid suppression therapy for laryngomalacia.","volume":"43","author":"Dang","year":"2022","journal-title":"Am J Otolaryngol"},{"issue":"6","key":"ooi250022r16","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1542\/peds.85.6.1034","article-title":"Stridor and gastroesophageal reflux in infants.","volume":"85","author":"Nielson","year":"1990","journal-title":"Pediatrics"},{"issue":"6 Pt 2","key":"ooi250022r17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/MLG.0b013e31804a5750","article-title":"Abnormal sensorimotor integrative function of the larynx in congenital laryngomalacia: a new theory of etiology.","volume":"117","author":"Thompson","year":"2007","journal-title":"Laryngoscope"},{"issue":"5","key":"ooi250022r18","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1542\/peds.2010-2719","article-title":"Efficacy of proton-pump inhibitors in infants with gastroesophageal reflux disease: a systematic review.","volume":"127","author":"van der Pol","year":"2011","journal-title":"Pediatrics"},{"key":"ooi250022r19","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jpeds.2016.11.035","article-title":"The edematous and erythematous airway does not denote pathologic gastroesophageal reflux.","volume":"183","author":"Rosen","year":"2017","journal-title":"J Pediatr"},{"issue":"2","key":"ooi250022r20","doi-asserted-by":"publisher","first-page":"109","DOI":"10.5223\/pghn.2022.25.2.109","article-title":"Clinical practice guidelines on pediatric gastroesophageal reflux disease: a systematic quality appraisal of international guidelines.","volume":"25","author":"Harris","year":"2022","journal-title":"Pediatr Gastroenterol Hepatol Nutr"},{"issue":"5","key":"ooi250022r21","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1016\/j.cgh.2006.02.016","article-title":"The infant gastroesophageal reflux questionnaire revised: development and validation as an evaluative instrument.","volume":"4","author":"Kleinman","year":"2006","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"2","key":"ooi250022r22","doi-asserted-by":"publisher","DOI":"10.1097\/PG9.0000000000000312","article-title":"Pilot study of inclined position and infant gastroesophageal reflux indicators.","volume":"4","author":"Paul","year":"2023","journal-title":"JPGN Rep"}],"container-title":["JAMA Otolaryngology\u2013Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2834959\/jamaotolaryngology_zalzal_2025_oi_250022_1752092939.42542.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T15:00:36Z","timestamp":1752159636000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2834959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2025.1201","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}