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  • Title: Failures and complications of supraglottoplasty in children.
    Author: Denoyelle F, Mondain M, Gresillon N, Roger G, Chaudre F, Garabedian EN.
    Journal: Arch Otolaryngol Head Neck Surg; 2003 Oct; 129(10):1077-80; discussion 1080. PubMed ID: 14568790.
    Abstract:
    OBJECTIVES: To study the failures and complications of bilateral supraglottoplasty in children with severe laryngomalacia and to compare children with isolated laryngomalacia (IL) with those who have additional congenital anomalies (ACAs). DESIGN: Retrospective medical record review. SETTING: Two tertiary referral centers. SUBJECTS: A total of 136 consecutive patients, aged 3 days to 60 months (median age, 3 months) who underwent laser or instrumental bilateral supraglottoplasty. Isolated laryngomalacia occurred in 102 children, aged 3 days to 19 months; ACAs were found in 34 children, aged 3 weeks to 60 months. OUTCOME MEASURES: Persistence of dyspnea, sleep apnea, and/or failure to thrive; need for further treatment; minor complications (defined as granuloma, edema, or small web); or major complication (supraglottic stenosis). RESULTS: Failures or partial improvement were observed in 12 (8.8%) of 136 cases, all having ACAs. The overall rate of complications was 7.4% (10/136). There were no significant differences between the IL and ACA groups concerning the rate of recurrence needing revision surgery (3/102, 2.9% vs 3/34, 9%), the rate of minor complications (4/102, 3.9% vs 1/34, 3%), or the rate of supraglottic stenosis (4/102, 3.9% vs 1/34, 3%). Supraglottic stenosis was managed by revision surgery in 4 cases and/or noninvasive ventilatory assistance in 2 cases. The long-term outcome appeared to be better when reintervention could be avoided or was kept to a minimum. CONCLUSION: Failure of supraglottoplasty was only observed in cases of laryngomalacia with ACAs. The complication rate was similar whether or not ACAs were present.
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