A 2-month-old male with a prior diagnosis of laryngomalacia (LM) presented to the emergency department in respiratory distress with worsening inspiratory stridor, suprasternal retractions, and a dry cough. A chest X-ray and lateral neck radiograph were performed and demonstrated no abnormalities. Flexible laryngoscopy revealed the same, previously observed moderately prolapsed arytenoids and an omega-shaped epiglottis with shortened aryepiglottic (AE) folds. He also had a right lower neck mass. He was scheduled for a direct laryngoscopy and bronchoscopy (DLB) and supraglottoplasty. During the DLB, LM and anterior compression of the midtrachea was noted. Lysis of the AE folds was performed in cold-steel fashion, and the infant was then taken for further imaging
