Background: Outcomes of the different management in severe laryngomalacia (LM) have not been evaluated.

Objective: To identify the management practices and to evaluate the outcomes in patient with severe LM.

Material and Method: The medical records of LM at Queen Sirikit National Institute Child Health between January2007 and December 2012 were retrospectively reviewed.

Results: Severe LM 69.8% (30/43) were found in patients diagnosed with LM. Type B (complete collapse) at 46.67% were the most common finding. Decision of management were made individually based on consideration of disease severity and comorbidity. The outcomes after management were evaluated by pre- and post-symptoms score. Post-symptoms scores were statistically significant better than pre-symptom score in all management (observation p<0.001, laser supraglottoplasty p = 0.003, and tracheotomy p = 0.001).

Conclusion: Our management in severe LM include: observation, laser supraglottoplasty, and tracheostomy. The overall post-management outcome were satisfactory but the present study was limited to relatively small number of patients.

Keywords: Laryngomalacia (LM), pre- and post-symptoms score, Tracheostomy, Laser supraglottoplasty