Abstract
Objective: 1) To examine the characteristics of patients undergoing supraglottoplasty for the treatment of laryngomalacia. 2) To better understand the features of laryngomalacia that may predispose patients to the need for future supraglottoplasty.
Method: Retrospective case series evaluating patients who underwent supraglottoplasty for laryngomalacia at our academic tertiary care children’s hospital between 2005 and 2012 and examining their demographic information, medical comorbidities, symptoms, indications for surgery, operative findings and procedure, site of laryngeal obstruction, operative techniques, and surgical success rates.
Results: Fifteen patients with laryngomalacia underwent seventeen procedures. The most common indications for supraglottoplasty were persistent stridor (93.3%), difficulty feeding (53.3%), and failure to thrive (33.3%). The most common comorbidities were gastroesophageal reflux (86.7%) and cardiopulmonary disease (40%). Operative findings included shortened aryepiglottic folds in 14 patients (93.3%), retropositioned epiglottis in 14 (93.3%), and prolapsed arytenoids in 4 (26.7%). Thirteen patients (86.7%) underwent division of the aryepiglottic folds and 4 underwent ablation of arytenoid mucosa (26.7%). Of the 14 patients who had followed up at the study conclusion, 13 (92.9%) had symptom improvement and 9 (64.3%) had complete resolution of their symptoms.
Conclusion: Supraglottoplasty is an effective treatment for laryngomalacia. Outcomes in our patients are similar to those reported in prior literature. The findings of shortened aryepiglottic folds and a retropositioned epiglottis appear to be disproportionately represented in our cohort of patients undergoing supraglottoplasty.
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