Supraglottoplasty outcomes in relation to age and comorbid conditions

Hoff, Stephen R.; Schroeder, James W.; Rastatter, Jeff C.; Holinger, Lauren D.

doi:10.1016/j.ijporl.2009.11.012

Cited by 68 publications

(104 citation statements)

References 15 publications

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“…A similar trend of older patients has been reported. 5 The success rate of SGP in patients with a neurologic comorbidity in the present study was 74% and, although significantly higher tracheostomy rates were identified in patients with cerebral palsy, only 2 of 31 patients (6%) in the neurologic comorbidity group required tracheostomy. Higher tracheostomy rates (eg, 55% 4 and 60% 5 ) were not seen.…”

Section: Neurologic Comorbiditiescontrasting

confidence: 45%

“…We therefore stratified patients based on age to evaluate the patterns of presentation of LM. Age-based stratification was attempted by Hoff and colleagues, 5 who reported that patients younger than 2 months may have a higher incidence of SGP failure, even in the absence of comorbidities. Infants in both groups mainly presented with acute airway obstruction.…”

Section: Age At Presentationmentioning

confidence: 99%

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Supraglottoplasty Outcomes in Neurologically Affected and Syndromic Children

Durvasula

Lawson

Bower

et al. 2014

JAMA Otolaryngol Head Neck Surg

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Section: Neurologic Comorbiditiescontrasting

confidence: 45%

Section: Age At Presentationmentioning

confidence: 99%

Supraglottoplasty Outcomes in Neurologically Affected and Syndromic Children

Durvasula

Lawson

Bower

et al. 2014

JAMA Otolaryngol Head Neck Surg

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“…Our overall success rate was 87%, the results in children without associated neurologic anomalies being better, with resolution in 96%. Nevertheless, children with comorbidities, particularly those with neurologic anomalies, seem to be at higher risk for treatment failure [17][18][19][20][21]. The literature regarding those patients is scarce, rendering their analysis difficult.…”

Section: Discussionmentioning

confidence: 99%

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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“…In the same study, only 2 of 41 neurologically intact children required further surgery, both of whom had mandibular hypoplasia. A similar study by Hoff et al 3 revealed that 7 of 10 children with neurologic deficits who underwent supraglottoplasty required further surgical intervention, 6 of whom ultimately required tracheotomy. Our study has several limitations.…”

Section: Discussionmentioning

confidence: 81%

“…[1][2][3][4][5][6][7] Advances in surgical management of subglottic stenosis have produced high rates of successful decannulation; however, children with neurologic deficit and upper airway obstruction do not achieve the same outcomes as unaffected children undergoing similar surgeries. [3][4][5] Dynamic obstruction of the pharyngeal and laryngeal airway is common in infants and in older children with hypotonia. A 2005 study of children with obstructive sleep apnea demonstrated that dynamic airway collapse in infants without neurologic deficits decreased progressively as those children aged.…”

mentioning

confidence: 99%