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Supraglottoplasty in severe laryngomalacia: impact on weight gain and symptoms resolution in infants
Enrique G Ortiz-Hernández1, Ingrid Valladolid1, Athziri Silva1
1Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello.
IntroduccióN:
La laringomalacia es la principal causa congénita de estridor en pediatría. Su tratamiento depende de la gravedad; los casos graves que cursan con apneas o falta de ganancia ponderal requieren intervención quirúrgica, siendo la supraglotoplastia el tratamiento de elección, logrando generalmente la resolución de síntomas.
MéTodos:
Se realizó un estudio descriptivo longitudinal mediante una cohorte retrospectiva. Se analizaron los expedientes de pacientes con el diagnóstico de laringomalacia grave a los que se les haya realizado supraglotoplastia, obteniendo datos sociodemográficos, síntomas principales, así como su evolución posquirúrgica, peso prequirúrgico y ganancia ponderal al mes del procedimiento, además de complicaciones quirúrgicas.
Resultados:
Se incluyeron 19 pacientes (16 de sexo masculino y 3 de sexo femenino), cuya edad media fue de 3.16 meses. El síntoma principal fue estridor y el 36.9% presentó como enfermedad concomitante reflujo gastroesofágico. La supraglotoplastia tuvo un éxito del 68.4% en el primer mes posquirúrgico y posterior del 100% durante el seguimiento. Todos los pacientes mostraron ganancia de peso y el 15% alcanzó un peso adecuado para su edad.
Conclusiones:
La supraglotoplastia se confirma como tratamiento eficaz para la laringomalacia grave, ya que logra resolver síntomas respiratorios y mejora el estado nutricional de los pacientes, aumentando su ganancia ponderal.
Background:
Laryngomalacia is the leading congenital cause of stridor in pediatrics. Its management depends on severity; severe cases accompanied by apnea or poor weight gain require surgical intervention, with supraglottoplasty being the treatment of choice, generally resulting in symptom resolution.
Methods:
A longitudinal descriptive study was conducted through a retrospective cohort. Medical records of patients diagnosed with severe laryngomalacia who underwent supraglottoplasty were analyzed, collecting sociodemographic data, main symptoms, post-surgical evolution, pre-surgical weight, and weight gain one month after the procedure, as well as surgical complications.
Results:
A total of 19 patients (16 males and 3 females) were included, with a mean age of 3.16 months. The main symptom was stridor, and 36.9% had concomitant gastroesophageal reflux disease. Supraglottoplasty had a success rate of 68.4% in the first postoperative month and 100% during follow-up. All patients showed weight gain, with 15% achieving an adequate weight for their age.
Conclusions:
Supraglottoplasty is confirmed as an effective treatment for severe laryngomalacia, as it resolves respiratory symptoms and improves the nutritional status of patients by increasing their weight gain.
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