Effect of Supraglottoplasty on congenital tracheomalacia

Evaluation of the effect of supraglottoplasty on co-existing tracheomalacia in pediatric patients with congenital laryngotracheomalacia to establish the venturi effect in vivo.

A prospective interventional study was conducted in a tertiary care hospital from 2020 to 2024. All consecutive pediatric patients undergoing supraglottoplasty for congenital laryngomalacia, with co-existing tracheomalacia on pre-operative bronchoscopic assessment were included and were assessed for change in severity of tracheomalacia by bronchoscopy and clinical parameters post-surgery as a comparison to the preoperative period.

Twenty-eight patients including sixteen boys and twelve girls aged 1-30 months underwent supraglottoplasty. Statistically significant reduction in tracheal collapse was noted in all twenty-eight patients post-surgery on bronchoscopic evaluation (mean reduction by 41.45 ± 9.72 %). Clinically significant improvement was seen in terms of severity of stridor, frequency of hospitalization, apparent life-threatening events, z score for weight for age and parental perception of resolution of symptoms of their ward.

Supraglottoplasty for correction of laryngomalacia results in significant improvement in co-existing tracheomalacia. Associated medical comorbidities were not found to affect the positive outcome. Supraglottoplasty being a simple surgery with insignificant complication rate and very high success rate may be considered as the first line of surgical intervention in severely symptomatic pediatric patients with laryngotracheomalacia.