We apologize to Dr Cotton that his name is not mentioned in the body of the text because it was added to the letter to the editor after the response to Drs Bluestone and Healy was sent.
We are pleased that Drs Bluestone and Healy, have chosen to comment on our recent article. Since these 2 eminent pediatrie otolaryngologists have vast experience in the treatment of children with stridor, their concerns must be taken seriously. We would like to address their concerns.
The article by Gonzales et al1 mentioned by the authors in their letter was a retrospective analysis of 103 infants who presented to the Children's Hospital of Pittsburgh, Pa, with airway obstruction, stridor, or both. Laryngomalacia was found in 59 patients, other laryngeal abnormalities in 19, subglottic lesions in 23, and trachabnormalities in 20. The authors found multiple synchronous lesions in 17.5% of the patients. Thus, the authors concluded that complete upper and lower airway examination by rigid endoscopy is necessary in evaluating infants with airway obstruction.
Mancuso RF, Choi SS, Zalzal GH, Grundfast KM. Diagnosis of Laryngomalacia Is Not Enough!-Reply. Arch Otolaryngol Head Neck Surg. 1996;122(12):1417–1418. doi:10.1001/archotol.1996.01890240123029
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