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Post-operative safety of pediatric supraglottoplasty: Is post-operative admission necessary?
Ani Mnatsakanian1, Jithin John2, Anya Costeloe1
1Department of Otolaryngology - Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, MI, USA.
Insights
Supraglottoplasty is a safe procedure for pediatric patients with severe laryngomalacia. This study found a low incidence of adverse events, suggesting hospital admission may not be necessary for healthy children post-surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Respiratory Medicine
Background:
- Severe laryngomalacia can significantly impact a child's quality of life and respiratory function.
- Supraglottoplasty is a surgical intervention aimed at improving airway patency in affected infants and children.
Purpose of the Study:
- To determine the incidence of acute (48 hours) and subacute (14 days) adverse events following pediatric supraglottoplasty.
- To evaluate the necessity of postoperative hospital admission for pediatric patients undergoing supraglottoplasty.
Main Methods:
- Retrospective chart review of 107 pediatric patients who underwent supraglottoplasty between January 2017 and December 2020.
- Data collection included patient demographics, length of hospital stay, comorbidities, adverse events, and readmissions within 14 days.
- Analysis focused on identifying the incidence and types of postoperative complications.
Main Results:
- The overall incidence of postoperative adverse events was 5.7% (6 out of 107 patients).
- The most frequent complications included respiratory distress, substernal retractions, stridor, and decreased oral intake.
- No statistically significant difference in adverse event incidence was observed based on the unit of postoperative hospital stay.
Conclusions:
- Supraglottoplasty is a safe and effective surgical treatment for severe laryngomalacia in pediatric patients.
- The study suggests that routine postoperative hospital admission may not be required for otherwise healthy children following supraglottoplasty.
Objectives:
The purpose of this study was to determine the incidence of adverse events in the first 48 h (acute) 14 days (subacute) in post supraglottoplasty pediatric patients. A secondary aim was to determine if postoperative hospital admission after supraglottoplasty in pediatric patients is necessary.
Methods:
This study was a retrospective review of pediatric patients who underwent supraglottoplasty at a tertiary care center. Data were obtained from January 2017-December 2020, totaling 107 patients. Pediatric patients who underwent supraglottoplasty were included in the study. Information regarding patients' demographics, length of postoperative hospital stay, comorbid conditions, unit of hospital admission, intraoperative and postoperative adverse events, and readmission within the first 14 days was gathered and analyzed.
Results:
The incidence of postoperative adverse events for all subjects after supraglottoplasty was 5.7 % (N = 6). The most common postoperative complications were respiratory distress (N = 2), followed by substernal retractions, stridor, and decreased oral intake (N = 1). There was no statistically significant increased incidence in any group of patients, regardless of their unit of stay post-operatively (p = 0.39).
Conclusions:
Supraglottoplasty is a safe surgical option for patients with severe laryngomalacia. While each patient's care is individualized, we demonstrate that post-operative hospital admission is not necessary for healthy children undergoing supraglottoplasty.
Level Of Evidence:
III - This is a retrospective chart review.
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