{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T15:26:29Z","timestamp":1758813989043,"version":"3.41.0"},"reference-count":48,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":58,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003The classification and management of laryngomalacia are challenging topics that are continuously updated and modified by pediatric airway surgeons. However, a numerical stratification of the patients to decide on the conservative management or intervention has not yet been established.<\/jats:p><jats:p>\n          Objective\u2003To provide an easy approach to cases of laryngomalacia by adopting an updated scoring system with a stepwise management algorithm.<\/jats:p><jats:p>\n          Methods\u2003We conducted a prospective study that included patients diagnosed with laryngomalacia over three years. The proposed symptom and history score was used to categorize patients into mild, moderate, and severe grades. Then, the examination and investigation scores designed were applied to the selected cases according to the management algorithm. Basic data from the patients and their flow throughout the study were assessed.<\/jats:p><jats:p>\n          Results\u2003The study included 112 patients with a mean age of 4.3\u2009\u00b1\u20092.2 months. In total, 44 (39.3%) cases were considered mild, 48 (42.86%), moderate, and 20 (17.85%), severe. The examination score was used to assess 68 out of 112 patients, including all moderate and severe cases of laryngomalacia. All of the mild cases were followed up, and none required surgery. The investigation score was applied to 55 cases, including all the severe cases, as preoperative evaluation, and 35 out of 48 moderate cases.<\/jats:p><jats:p>\n          Conclusion\u2003This newly proposed scoring system with the associated algorithm is an easily applicable way to deal with, classify, and properly manage laryngomalacia cases.<\/jats:p>","DOI":"10.1055\/s-0044-1801317","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T22:43:01Z","timestamp":1748558581000},"page":"001-012","source":"Crossref","is-referenced-by-count":1,"title":["New Numerical Score and Stepwise Algorithm for the Classification and Management of Laryngomalacia"],"prefix":"10.1055","volume":"29","author":[{"given":"Ahmed","family":"Elsobki","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemmat","family":"Baz","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reham AE","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics, Faculty of Medicine, Assuit University, Assuit, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menna Ibrahim","family":"Hashish","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6029-8529","authenticated-orcid":false,"given":"Mohamed E.","family":"El-Deeb","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noha Ahmed","family":"El-Kholy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"ref1","first-page":"3","article-title":"Laryngomalacia: review and summary of current clinical practice in 2015","volume":"17","author":"M C Thorne","year":"2016","journal-title":"Paediatr Respir Rev"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.otc.2008.04.011","article-title":"The surgical management of laryngomalacia","volume":"41","author":"G T Richter","year":"2008","journal-title":"Otolaryngol Clin North Am"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.ijporl.2016.04.007","article-title":"International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations","volume":"86","author":"J Carter","year":"2016","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref4","doi-asserted-by":"crossref","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":"D M Thompson","year":"2007","journal-title":"Laryngoscope"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ijporl.2016.12.039","article-title":"Utility of polysomnography in determination of laryngomalacia severity","volume":"93","author":"J E Weinstein","year":"2017","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.ijporl.2008.01.002","article-title":"Synchronous airway lesions in laryngomalacia","volume":"72","author":"E Krashin","year":"2008","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref7","first-page":"17","volume-title":"World Health Organization child growth standards","author":"M de Onis","year":"2017"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1002\/lary.25440","article-title":"Laryngomalacia and swallowing function in children","volume":"126","author":"J P Simons","year":"2016","journal-title":"Laryngoscope"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/cch.12796","article-title":"Child development assessment: Practitioner input in the revision for Griffiths III","volume":"46","author":"E M Green","year":"2020","journal-title":"Child Care Health Dev"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4103\/bbrj.bbrj_4_19","article-title":"Evaluation of pulmonary hypertension in stable chronic obstructive pulmonary disease patients using transthoracic echocardiography","volume":"3","author":"S Purohit","year":"2019","journal-title":"Biomed Biotechnol Res J"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1067\/mpd.2002.123290","article-title":"Night-to-night variability of polysomnography in children with suspected obstructive sleep apnea","volume":"140","author":"E S Katz","year":"2002","journal-title":"J Pediatr"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"110984","DOI":"10.1016\/j.ijporl.2021.110984","article-title":"Synchronous airway lesions in children with severe, progressive and atypical laryngomalacia - Experience of a UK tertiary referral centre","volume":"152","author":"N Glibbery","year":"2022","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1001\/jamaoto.2018.3642","article-title":"Evaluation of aspiration in infants with laryngomalacia and recurrent respiratory and feeding difficulties","volume":"145","author":"A L Irace","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.jpeds.2012.10.041","article-title":"Diagnostic accuracy of tests in pediatric gastroesophageal reflux disease","volume":"162","author":"R J van der Pol","year":"2013","journal-title":"J Pediatr"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/pan.12922","article-title":"Pediatric perioperative adverse events requiring rapid response: a retrospective case-control study","volume":"26","author":"L E Schleelein","year":"2016","journal-title":"Paediatr Anaesth"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1097\/MOO.0b013e3283405e48","article-title":"Laryngomalacia: factors that influence disease severity and outcomes of management","volume":"18","author":"D M Thompson","year":"2010","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1288\/00005537-198902000-00004","article-title":"Surgical management of severe laryngomalacia","volume":"99","author":"L D Holinger","year":"1989","journal-title":"Laryngoscope"},{"issue":"01","key":"ref18","first-page":"29","article-title":"Epiglottoplasty in the treatment of laryngomalacia","volume":"22","author":"A Zeitouni","year":"1993","journal-title":"J Otolaryngol"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1097\/00005537-199911000-00009","article-title":"Laryngomalacia and its treatment","volume":"109","author":"D R Olney","year":"1999","journal-title":"Laryngoscope"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1007\/BF03009914","article-title":"Congenital laryngomalacia","volume":"41","author":"M R Baxter","year":"1994","journal-title":"Can J Anaesth"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0165-5876(98)00111-6","article-title":"Laryngomalacia: a proposed classification form","volume":"46","author":"U K Shah","year":"1998","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"10","key":"ref22","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1001\/jamaoto.2014.1843","article-title":"Factors associated with the morphological type of laryngomalacia and prognostic value for surgical outcomes","volume":"140","author":"B Erickson","year":"2014","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1288\/00005537-199510000-00018","article-title":"Severe laryngomalacia: surgical indications and results in 115 patients","volume":"105","author":"G Roger","year":"1995","journal-title":"Laryngoscope"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1177\/000348948709600118","article-title":"Epiglottoplasty for the treatment of laryngomalacia","volume":"96","author":"G H Zalzal","year":"1987","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"07","key":"ref25","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1177\/0003489420965636","article-title":"Flexible endoscopic evaluation of swallowing in breastfeeding infants with laryngomalacia: observed clinical and endoscopic changes with alteration of infant positioning at the breast","volume":"130","author":"N Mills","year":"2021","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1542\/peds.68.1.36","article-title":"Apgar scores as predictors of chronic neurologic disability","volume":"68","author":"K B Nelson","year":"1981","journal-title":"Pediatrics"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/j.1651-2227.1979.tb04980.x","article-title":"Long-term prognosis of infants with idiopathic respiratory distress syndrome. Follow-up studies in infants surviving after the introduction of continuous positive airway pressure","volume":"68","author":"J Kamper","year":"1979","journal-title":"Acta Paediatr Scand"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1258\/0022215011906966","article-title":"Aryepiglottoplasty for laryngomalacia: 100 consecutive cases","volume":"115","author":"S C Toynton","year":"2001","journal-title":"J Laryngol Otol"},{"issue":"10","key":"ref29","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1001\/archotol.129.10.1077","article-title":"Failures and complications of supraglottoplasty in children","volume":"129","author":"F Denoyelle","year":"2003","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"07","key":"ref30","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1001\/archoto.2009.73","article-title":"Synchronous airway lesions and outcomes in infants with severe laryngomalacia requiring supraglottoplasty","volume":"135","author":"J W Schroeder Jr","year":"2009","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.ijporl.2009.11.012","article-title":"Supraglottoplasty outcomes in relation to age and comorbid conditions","volume":"74","author":"S R Hoff","year":"2010","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"16","key":"ref32","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1002\/ajmg.a.31851","article-title":"Upper airway obstruction in neonates and infants with CHARGE syndrome","volume":"143A","author":"Y Naito","year":"2007","journal-title":"Am J Med Genet A"},{"issue":"03","key":"ref33","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/ppul.10156","article-title":"Series of laryngomalacia, tracheomalacia, and bronchomalacia disorders and their associations with other conditions in children","volume":"34","author":"I B Masters","year":"2002","journal-title":"Pediatr Pulmonol"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1001\/archotol.127.6.694","article-title":"Unilateral vs. bilateral supraglottoplasty for severe laryngomalacia in children","volume":"127","author":"D K Reddy","year":"2001","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"08","key":"ref35","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1002\/lary.21025","article-title":"Prevalence of laryngomalacia in children presenting with sleep-disordered breathing","volume":"120","author":"M Thevasagayam","year":"2010","journal-title":"Laryngoscope"},{"issue":"05","key":"ref36","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1001\/archotol.132.5.489","article-title":"Evaluation of the efficacy of supraglottoplasty in obstructive sleep apnea syndrome associated with severe laryngomalacia","volume":"132","author":"F CP Valera","year":"2006","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"10","key":"ref37","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1097\/MLG.0b013e31817e7441","article-title":"Supraglottoplasty for laryngomalacia with obstructive sleep apnea","volume":"118","author":"M E Zafereo","year":"2008","journal-title":"Laryngoscope"},{"issue":"01","key":"ref38","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/000348940911800107","article-title":"Secondary airway lesions in infants with laryngomalacia","volume":"118","author":"J M Dickson","year":"2009","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0165-5876(97)00151-1","article-title":"Gastroesophageal reflux association with laryngomalacia: a prospective study","volume":"43","author":"C Giannoni","year":"1998","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref40","first-page":"7","article-title":"Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease","volume":"81","author":"J A Koufman","year":"2002","journal-title":"Ear Nose Throat J"},{"issue":"06","key":"ref41","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S0194-5998(99)70327-X","article-title":"Reflux in infants with laryngomalacia: results of 24-hour double-probe pH monitoring","volume":"120","author":"B L Matthews","year":"1999","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"08","key":"ref42","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1097\/01.mlg.0000225942.33102.9b","article-title":"Improved infant swallowing after gastroesophageal reflux disease treatment: a function of improved laryngeal sensation?","volume":"116","author":"D L Suskind","year":"2006","journal-title":"Laryngoscope"},{"issue":"04","key":"ref43","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1177\/000348940911800404","article-title":"Impact of supraglottoplasty on aspiration in severe laryngomalacia","volume":"118","author":"G T Richter","year":"2009","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"02","key":"ref44","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1007\/s00405-021-07130-8","article-title":"Coblation supraglottoplasty: a ten-year experience in a tertiary referral hospital","volume":"279","author":"A El-Sobki","year":"2022","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref45","doi-asserted-by":"crossref","DOI":"10.1053\/j.sempedsurg.2016.02.004","volume-title":"Laryngomalacia","author":"J Bedwell","year":"2016"},{"issue":"07","key":"ref46","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.ijporl.2014.04.015","article-title":"Characteristics of patients undergoing supraglottoplasty for laryngomalacia","volume":"78","author":"F G Garritano","year":"2014","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"01","key":"ref47","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/s12070-022-03307-7","article-title":"Surgical Candidacy for Management of Laryngomalacia: A Proposed Scoring System","volume":"75","author":"D Shivnani","year":"2023","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"issue":"08","key":"ref48","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1001\/archoto.2012.1251","article-title":"A systematic review of supraglottoplasty outcomes","volume":"138","author":"D Preciado","year":"2012","journal-title":"Arch Otolaryngol Head Neck Surg"}],"container-title":["International Archives of Otorhinolaryngology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1801317.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T22:43:07Z","timestamp":1748558587000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1801317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":48,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,4,15]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["s00441801317"],"URL":"https:\/\/doi.org\/10.1055\/s-0044-1801317","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1809-9777","1809-4864"],"issn-type":[{"value":"1809-9777","type":"print"},{"value":"1809-4864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}