Generally laryngomalacia is associated principally with noisy breathing and feeding difficulties. It is possible to have severe enough laryngomalacia that the loss of tone is resulting in the apneas/cessations of breathing, this would be called sleep-dependent laryngomalacia which is becoming increasingly recognized in the last few years.The true fact of the matter is there is a 5 month old with severe sleep apnea who is working on growing. Sleep apnea has significant impact on children and can impair development.It is also unclear if a scope examination has been done while the baby is awake (through the nose) to see if there is any evidence of laryngomalacia as this can often be apparent at bedside as well. The caveat to this would be sleep dependent laryngomalacia wouldn't be (because baby isn't asleep)When I was at a children's hospital and worked with some people that did blanket consents like that, it didn't always mean that the surgery would be performed, only if there were findings concerning enough to warrant the intervention. You have the option to talk to the surgeon and ask they call you before performing the procedure or discussing what they find. I've done that with plenty of folks. That being said, a supraglottoplasty is very well tolerated overall and those kids do tend to do much better.
Thank you for replying!I tried to address some of those things in my post. It sounds like I wasnt clear, so Ill try again.Ive been told by 2 different doctors that he no longer has an oxygen requirement, however the initial doctor who began the oxygen wants to keep him on it until the scopes.Baby is not failure to thrive. He was born less than 1 percentile due to IUGR. He is currently in the 7 percentile. He has been growing and gaining weight consistently along his curve. Weve seen GI and several nutritionists and feeding specialists (the specialists here see in co-managing groups) and everyone is very happy with how he is feeding and how he is gaining.He does not have, and has not had, any feeding issues. No tiring during feeds. No sweating. No desats during feeds. He has a bit of reflux, which GI said is normal and needs no treatment.There is no noisy breathing when agitated. He is not noisy during sleep.The impression Ive gotten is that laryngomalacia is being looked at as a possibility due to apnea. I also understand that typically oxygen drops during these events, and his did not. I think I was seeking some opinion on this in my post, though I wasnt clear. Can apnea be the only symptom of laryngomalacia requiring treatment?I absolutely think the scopes are necessary. Im totally on board with looking. I think this is why Im feeling challenged in giving blanket consent to cutting going in, though. To me, based on the research Ive done, it doesnt sound like he has other symptoms of laryngomalacia.I was hoping I might get additional insight here, and perhaps even find other pathways to research and explore. I appreciate you taking time to respond!