Transcervical Epiglottopexy for the Management of Type 3 Laryngomalacia.

Type 3 laryngomalacia (LM) is characterized by prolapse of the epiglottis into the airway. Endolaryngeal suturing is technically challenging considering the limited exposure. In the present article, we describe a simple technique of transcervical epiglottopexy (TE) via an exo-endolaryngeal technique using an 18-G needle prethreaded with a 2-0 Prolene suture in a looped fashion inserted through the inferior epiglottis. Another 20-G needle with a 2-0 Prolene suture with one free end is inserted above the previous stitch through the superior epiglottis. The single stitch is passed through the looped stitch, which is then pulled through the neck, leaving a single stitch precisely placed through the epiglottis. We have used this technique safely while achieving epiglottopexy in 3 cases of epiglottic prolapse. We describe a method of TE using easily available instruments. This method we believe can easily be adapted for any kind of epiglottic prolapse.