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Practice patterns in supraglottoplasty and perioperative care
Vaibhav H Ramprasad1, Marisa A Ryan1, Alfredo E Farjat2
1Division of Otolaryngology-Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, DUMC 3805, Durham, NC 27710, USA.
Summary
This study surveyed otolaryngologists on supraglottoplasty practices for severe laryngomalacia. Findings reveal varied techniques and post-operative care, with cold steel most popular and a trend towards intensive care admissions.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Surgery
Background:
- Severe laryngomalacia is commonly treated with supraglottoplasty.
- Understanding current practice patterns is crucial for optimizing care.
Purpose of the Study:
- To determine current practice patterns in the management of children undergoing supraglottoplasty.
- To identify trends in surgical techniques and perioperative care.
Main Methods:
- A 25-question survey was distributed to 274 members of the Society for Ear, Nose and Throat Advances in Children (SENTAC).
- The survey focused on supraglottoplasty techniques and perioperative management.
- Responses from 101 surgeons across various regions were analyzed.
Main Results:
- Cold steel is the most common surgical technique (73%), followed by laser, microdebrider, and coblator.
- Most surgeons (89%) manage reflux with pharmacotherapy (PPIs or H2 blockers).
- Post-operative care varies, with 53% admitting patients to the Pediatric Intensive Care Unit (PICU), often associated with lower surgical volume and specific geographic regions.
Conclusions:
- Significant variations exist in supraglottoplasty techniques and perioperative management among otolaryngologists.
- While anti-reflux pharmacotherapy is common, consensus on the specific agents is lacking.
- Further research is needed to establish optimal, cost-effective management strategies for patients undergoing supraglottoplasty.
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