Unilateral vs Bilateral Supraglottoplasty for Severe Laryngomalacia in Children

Reddy, Deepkaran K.; Matt, Bruce H.

doi:10.1001/archotol.127.6.694

Cited by 83 publications

(76 citation statements)

References 12 publications

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“…Over the last 20 years, endoscopic supraglottoplasty has become the procedure of choice for this condition. According to the literature, supraglottoplasty has a success rate of 70-100% [13,15,16]. Our overall success rate was 87%, the results in children without associated neurologic anomalies being better, with resolution in 96%.…”

Section: Discussionmentioning

confidence: 62%

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

Escher

Probst

Gysin

2015

Journal of Pediatric Surgery

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BACKGROUND/IMPORTANCE: Supraglottoplasty is the surgical procedure of choice for severe laryngomalacia and has shown to be successful in most cases; however, patients with medical comorbidities present a higher rate of failure. To date, the best management of laryngomalacia in children with congenital syndrome remains unclear. PURPOSE: To study the outcome of supraglottoplasty in children with severe laryngomalacia, and to analyze the management and outcome in infants with a congenital syndrome. METHODS: Retrospective medical records review from January 2003 to October 2012 of all patients who underwent laser supraglottoplasty for severe laryngomalacia at the University Children's Hospital Zurich, Switzerland. RESULTS: Thirty-one patients were included; median age at time of surgery was 3.5 months. Three patients (10%) had a genetically proven congenital syndrome with associated neurologic anomalies. Overall success rate was 87%. Failures were observed in four (13%) of 31 cases; including all three patients presenting a congenital syndrome. CONCLUSIONS: Supraglottoplasty is an effective and safe treatment for laryngomalacia in otherwise healthy children. Signs of a possible underlying predominant neurologic origin and discrepancy between the clinical presentation and the endoscopic findings have to be taken into account, as in children with congenital syndrome with neurologic anomalies the risk of failure is higher.

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Section: Discussionmentioning

confidence: 62%

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

Escher

Probst

Gysin

2015

Journal of Pediatric Surgery

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“…The technique employed -section of aryepiglottic folds, was described for the first time by Hasslinger 6 , and later it was disseminated by many different authors 16,23,24 . Lane 10 , in 1984, described the use of micro-scissors to section the aryepiglottic folds as a treatment option for pectus excavatum.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors suggest unilateral section of aryepiglottic fold 17,[23][24][25] with good results, but about 15% of the patients still require contralateral procedure.…”

Section: Discussionmentioning

confidence: 99%

O tratamento da laringomalácia: experiência em 22 casos

Avelino

Liriano

Fujita

et al. 2005

Rev. Bras. Otorrinolaringol.

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Laryngomal acia is the most frequent cause of stridor in childhood, and in most of the cases, spontaneous resolution occurs by the age of 2 years. Approximately 10% of the cases (severe laryngomalacia) require surgery. This condition is of unknown etiology and its diagnosis is made by fiberoptic laryngoscopy, which shows shortening of the aryepiglottic folds, and/or redundant arytenoid mucosa, and/or anterior-posterior epiglottic prolapse. Aim: Our objective was to verify the main clinical and anatomical affections and to highlight the clinical parameters for clinical follow-up and surgical indication in patients with laryngomalacia. Study design: Transversal cohort study. Material and Method: Twenty-two children diagnosed with laryngomalacia in the Pediatric Otorhinolaryngology of UNIFESP-EPM, from January 2001 to December 2003, whose clinical and surgical follow-up were performed by the same examiner, were enrolled in this study. Results: Out of twenty-two evaluated children, 2 (9.1%) presented with severe laryngomalacia and pectus excavatum (funnel chest). At polysomnography, no child presented any significant respiratory event during sleeping. Those two children with severe laryngomalacia were submitted to supraglottoplasty with resection of the aryepiglottic folds. Conclusion: We concluded that stridor and shortening of the aryepiglottic folds are preponderant in children with laryngomalacia. The polysomnographic exam did not prove to be a good parameter for clinical follow-up, neither for surgical indication. The most important parameters were pectus excavatum and failure to thrive. Supraglottoplasty is effective and has low morbidity rate.

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“…However, surgical complications like supraglottic stenosis can occur in a minority of patients [22]. Although infrequent, the difficulty in the management of this complication has led some investigators to recommend unilateral supraglottoplasty as an initial alternative, with the option of a staged contralateral operation for persistent symptoms [23]. Either way, avoiding overaggressive removal of supraglottic tissue and preservation of an intact strip of interarytenoid mucosa are important surgical principles that can minimize the possibility of this complication.…”

Section: Introductionmentioning

confidence: 99%

Does Reflux Have a Causative Role in Laryngomalacia?

Manaligod¹

2013

Otolaryngology

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Unilateral vs Bilateral Supraglottoplasty for Severe Laryngomalacia in Children

Cited by 83 publications

References 12 publications

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

O tratamento da laringomalácia: experiência em 22 casos

Does Reflux Have a Causative Role in Laryngomalacia?

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