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Unilateral endoscopic supraglottoplasty for severe laryngomalacia
1Division of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Md, USA.
Objective:
To evaluate the effectiveness of unilateral supraglottoplasty in the treatment of children with severe laryngomalacia.
Design:
Retrospective study.
Setting:
Pediatric tertiary referral center.
Patients:
Eighteen children with severe laryngomalacia. Indications for surgical intervention were obstructive apnea, failure to thrive, cyanosis, and/or cor pulmonale.
Interventions:
Unilateral carbon dioxide laser removal of redundant supraglottic tissue (supraglottoplasty).
Outcome Measures:
Evaluation of relief of symptoms, need for subsequent contralateral procedure, and incidence of complications.
Results:
Three patients required treatment of the opposite side at a later date. There were no complications. Obstructive apnea and weight gain improved in all.
Conclusions:
Unilateral supraglottoplasty can be used to treat severe laryngomalacia in most patients. A small percentage of patients will subsequently require a contralateral procedure. Unilateral supraglottoplasty may have less risk of complications than bilateral supraglottoplasty.