Abstract
Objectives:
Prematurity is thought to be to be an independent risk factor for supraglottoplasty (SGP) failure. This study aimed to compare the outcomes of SGP in premature (<36 weeks) versus term infants.
Methods:
Retrospective analysis was performed on 325 patients undergoing SGP between 2004 and 2012. Patients >12 months age, syndromic, or with neurological or cardiac comorbidities were excluded. Resolution of airway symptoms after SGP was considered a success while revision SGP and tracheostomy were considered failures. The rates of secondary airway lesions (SAL), dysphagia, and gastrostomy tube (GT) placement were also compared.
Results:
A total of 178 infants (138 term, 40 premature) were identified for the analysis. SGP was successful in 91% (126/138) term and 90% (36/40) premature infants with no significant difference (P = 0.8) in success rates. Twelve term infants and 3 preterm infants required revision SGP. One premature infant required tracheostomy. Incidence of SAL was significantly higher in premature (72.5%) compared to term infants (34.97%) (P = 0.0002). Intubation rates were significantly higher in premature infants. This did not affect the higher SAL in premature infants compared to term infants. Dysphagia rates were also higher in premature (13/40, 32.5%) versus term infants (10/138, 7.25%, P < 0.001) and lasted longer on follow-up. The rate of GT insertion was greater in premature (27.5%) compared to term infants (7.25%) (P = 0.003).
Conclusions:
Supraglottoplasty outcomes in term and premature infants were similar. However, premature infants experience significantly more SAL and dysphagia.
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