Changes in sleep apnea after supraglottoplasty in infants with laryngomalacia

Treatment outcomes of supraglottoplasty for pediatric obstructive sleep apnea: A meta-analysis

“…Complications after supraglottoplasty were rare and included failure to extubate [48], lung collapse [50], suture dislodgement [51], and abscess formation [58]. Revision surgeries, including tracheostomy [48], revision supraglottoplasty [51,52], and adenotonsillectomy [52,53], were occasionally performed in cases with residual disease. Adenotonsillectomy was considered a treatment option in children with persistent OSA after supraglottoplasty and adenotonsillar hypertrophy [52,53].…”

“…Revision surgeries, including tracheostomy [48], revision supraglottoplasty [51,52], and adenotonsillectomy [52,53], were occasionally performed in cases with residual disease. Adenotonsillectomy was considered a treatment option in children with persistent OSA after supraglottoplasty and adenotonsillar hypertrophy [52,53]. Fig.…”

“…Notably, children may have persistent OSA after adenotonsillar surgeries caused by noncongenital laryngomalacia, including occult laryngomalacia, lateonset laryngomalacia, and state-dependent laryngomalacia [37]. Occult laryngomalacia presents with stridor in children, limited to sleep or exercise [7,52]. Late-onset laryngomalacia begins at age 2 or older in patients without a medical history of prior diseases or symptoms [6,50].…”

Pediatric Obstructive Sleep Apnea Syndrome

“…Several reports have shown marked improvements in PSG parameters after supraglottoplasty as a treatment of clinically significant laryngomalacia. [76][77][78][79][80] When T&A fails to resolve OSAS, other surgical options exist. Palatal surgery, such as uvulopalatopharyngoplasty (UPPP), has been used to treat complicated OSAS in obese children, children with cerebral palsy, children with Down syndrome, as well as children with other neurologic impairments or craniofacial anomalies.…”

Trends in Inpatient Pediatric Polysomnography for Laryngomalacia and Craniofacial Anomalies

“…4 For otherwise healthy children with suspected OSA, performing outpatient PSG is considered a reasonable option for work-up; however, many children with significant medical comorbidities may undergo inpatient PSG within the first year of life. Over the past 10 years, multiple authors have reported an association between OSA and conditions such as laryngomalacia [5][6][7] and craniofacial anomalies. 5,8,9 Given that these conditions are commonly diagnosed in early infancy, one would expect that children with laryngomalacia or craniofacial anomalies and signs of sleep disordered breathing (SDB) would be more likely to undergo inpatient PSG than older, otherwise healthy children.…”