Surgical treatment of severe laryngomalacia: a retrospective study of 11 cases

Pinto, José Antônio; Wambier, Henrique; Mizoguchi, Elcio Izumi; Gomes, Leonardo Marques; Kohler, Rodrigo; Ribeiro, Renata C.

doi:10.5935/1808-8694.20130101

Cited by 9 publications

(7 citation statements)

References 30 publications

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“…Forty‐four studies were excluded for the following reasons: the number of patients undergoing polysomnography pre‐ and postsupraglottoplasty was not provided; no quantitative data for polysomnograms was provided; only adults were included; procedure(s) were performed in addition to the supraglottoplasty with no stratification of data for those who underwent isolated supraglottplasty; only preoperative data was available; some children were sedated with choral hydrate; the postoperative data was only available for a fraction of patients; portable pulse‐oximetry was used instead of formal polysomnography; or they were review articles …”

Section: Resultsmentioning

confidence: 99%

“…Forty-four studies were excluded for the following reasons: the number of patients undergoing polysomnography pre-and postsupraglottoplasty was not provided 43 ; no quantitative data for polysomnograms was provided 12,18,21,22,[24][25][26]28,29,[32][33][34][35][36][37][38][39]41,42,[44][45][46]49,51,53,54,56,58,61,64,66 ; only adults were included 19 ; procedure(s) were performed in addition to the supraglottoplasty with no stratification of data for those who underwent isolated supraglottplasty 27,50,63 ; only preoperative data was available 55 ; some children were sedated with choral hydrate 47 ; the postoperative data was only available for a fraction of patients 30 ; portable pulse-oximetry was used instead of formal polysomnography 31 ; or they were review articles. 40,52,62 Overall, there were a total of 138 patients (ages 1 month-12.6 years) with quantitative polysomnographic data who underwent isolated supraglottoplasty.…”

Section: Resultsmentioning

confidence: 99%

“…The searches yielded 517 studies, which were screened; 54 studies were reviewed in the full‐text version; and after reviewing the references, another three studies were potentially relevant and were also reviewed (57 total) . Thirteen studies met criteria for inclusion.…”

Section: Resultsmentioning

confidence: 99%

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Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

et al. 2015

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Objectives/Hypothesis: To determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve following isolated supraglottoplasty for laryngomalacia with obstructive sleep apnea (OSA) in children.Study Design: Systematic review and meta-analysis. Methods: Nine databases, including PubMed/MEDLINE, were searched through September 30, 2015.Results: A total of 517 studies were screened; 57 were reviewed; and 13 met criteria. One hundred thirty-eight patients were included (age range: 1 month-12.6 years). Sixty-four patients had sleep exclusive laryngomalacia, and in these patients: 1) AHI decreased from a mean (M) 6 standard deviation (SD) of 14.0 6 16.5 (95% confidence interval [CI] 10.0, 18.0) to 3.3 6 4.0 (95% CI 2.4, 4.4) events/hour (relative reduction: 76.4% [95% CI 53.6, 106.4]); 2) LSAT improved from a M 6 SD of 84.8 6 8.4% (95% CI 82.8, 86.8) to 87.6 6 4.4% (95% CI 86.6, 88.8); 3) standardized mean differences (SMD) demonstrated a small effect for LSAT and a large effect for AHI; and 4) cure (AHI < 1 event/hour) was 10.5% (19 patients with individual data). Seventy-four patients had congenital laryngomalacia, and in these patients: 1) AHI decreased from a M 6 SD of 20.4 6 23.9 (95% CI 12.8, 28.0) to 4.0 6 4.5 (95% CI 2.6, 5.4) events/hour (relative reduction: 80.4% [95% CI 46.6, 107.4]); 2) LSAT improved from a M 6 SD of 74.5 6 11.9% (95% CI 70.9, 78.1) to 88.4 6 6.6% (95% CI 86.4, 90.4); 3) SMD demonstrated a large effect for both AHI and LSAT; and 4) cure was 26.5% (38 patients with individual data).Conclusion: Supraglottoplasty has improved AHI and LSAT in children with OSA and either sleep exclusive laryngomalacia or congenital laryngomalacia; however, the majority of them are not cured.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

et al. 2015

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“…Stridor pada pasien LM dipengaruhi oleh aktivitas, akan timbul ketika bayi menangis, posisi tidur telentang, saat menyusu, infeksi saluran nafas atas dan saat marah. 1,8,9 Sekitar 80% kasus laringomalasia merupakan kasus ringan dan sedang yang membaik setelah 8-12 bulan serta resolusi dan sembuh setelah 12-24 bulan, namun 10-20% dari kasus merupakan derajat berat yang mengancam nyawa dan membutuhkan tindakan operasi segera. 3,6,10 Penyebab pasti dari laringomalasia ini masih belum diketahui, namun terdapat beberapa teori yang diduga menjadi Tinjauan Pustaka patogenesis LM yaitu teori imaturitas kartilago, abnormal anatomi dan imaturitas neuromuskular.…”

Section: Pendahuluanunclassified

“…3,4,9,10 Gejala klasik LM adalah didapatkannya stridor inspirasi yang makin berat ketika pasien gelisah, menangis, menyusu, makan dan tidur terlentang. [8][9][10] Hal lain yang perlu didapatkan adalah riwayat kelahiran pasien diantaranya berat dan panjang badan saat lahir, usia kehamilan saat lahir, kelainan genetik atau penyakit komorbid lainnya. Pada pemeriksaan fisik yang diperlukan adalah berat dan panjang anak saat pemeriksaan, suara nafas saat inspirasi dan ekspirasi, B gerakan dada untuk menilai adanya retraksi atau pectus excavatum, serta penilaian perfusi jaringan.…”

Section: Diagnosisunclassified

Diagnosis dan Penatalaksanaan Laringomalasia

Elfianto

Novialdi

2018

JKA

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AbstrakLatar belakang: Laringomalasia (LM) merupakan penyebab tersering stridor inspirasi kongenital pada bayi. Sekitar 80% kasus merupakan derajat ringan dan sedang yang dapat membaik serta resolusi sampai usia 2 tahun sedangkan 20% merupakan derajat berat yang membutuhkan tindakan pembedahan Tujuan: Mengetahui dan memahami etiologi, diagnosis dan penatalaksanaan laringomalasia. Tinjauan Pustaka: Diagnosis laringomalasia dapat ditegakkan dari anamnesis, pemeriksaan fisik serta pemeriksaan penunjang laringoskopi serat optic fleksibel. Etiologi pasti laringomalasia belum diketahui, namun terdapat 3 teori yang diduga berperan yaitu imaturitas kartilago, imaturitas neuromuskular dan abnormalitas anatomi. Terdapat hubungan antara laringomalasia dengan laryngopharyngeal reflux (LPR). Penatalaksanaan konservatif dilakukan pada LM derajat ringan dan sedang sedangkan tindakan pembedahan dilakukan pada derajat berat, laringomalasia dengan komorbid dan laringomalasia yang gagal terapi konservatif. Kesimpulan: Laringomalasia merupakan kolapsnya struktur supraglotis ketika inspirasi yang mengakibatkan adanya stridor inspirasi. Laringomalasia derajat berat dapat mengancam nyawa. Sebagian besar kasus akan resolusi sendiri, namun sekitar 20% memerlukan tindakan pembedahan. Supraglottoplasti merupakan tindakan pembedahan pilihan untuk kasus laringomalasia Kata kunci: Laringomalasia, stridor inspirasi, laringoskopi serat optik fleksibel, supraglottoplasti AbstractBackground : Laryngomalacia (LM) is the most common cause of inspiration stridor in infant. About 80% cases are mild and moderate that can improvement and resolution by 2 years of age, and aboout 20% cases is severe that need surgical intervention. Objective : Knowing and understanding etiology, diagnosis and management of laryngomalacia. Literature review :. Diagnosis of laryngomalacia is obtained from the history, phisical examination and supporting examination such as flexible fibreoptic laryngoscopy (FFL) . The etiology was unknown, but there are some theory that can explain cause of laryngomalacia such as cartilage immaturity, neuromuscular immaturity, an anatomic abnormality. There is corelation between laryngomalacia and laryngopharingeal reflux disease (LPR). Conservative treatment choosing for mild and moderate laryngomalacia and surgical intervention perform for severe laryngomalacia, laryngomalacia with comorbid disease and laryngomalacia which failed with conservative treatment. Conclusion : Laryngomalacia is a condition of supraglottic structure collaps into the airway during inspiratory phase that produce inspiration stridor and can make life threatening. Most of the cases are self limiting resolution, only about 20% need surgical intervention. Supraglottoplasty is the choice surgical procedure for laryngomalacia.

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Long term Follow Up of Severe Laryngomalacia Patients Following CO2 LASER Supraglottoplasty

Bhatta

Gandhi

Ganesuni

et al. 2020

Indian J Otolaryngol Head Neck Surg

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Surgical treatment of severe laryngomalacia: a retrospective study of 11 cases

Abstract: Supraglottoplasty proved to be effective and safe in the treatment of severe laryngomalacia.

Cited by 9 publications

References 30 publications

Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

Diagnosis dan Penatalaksanaan Laringomalasia

Long term Follow Up of Severe Laryngomalacia Patients Following CO2 LASER Supraglottoplasty

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