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December 1995

Unilateral Endoscopic Supraglottoplasty for Severe Laryngomalacia

Author Affiliations

From the Divisions of Otolaryngology—Head and Neck Surgery, The Johns Hopkins University, Baltimore, Md (Dr Kelly), and University of Utah Medical Center, Salt Lake City (Dr Gray).

Arch Otolaryngol Head Neck Surg. 1995;121(12):1351-1354. doi:10.1001/archotol.1995.01890120011002

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.(Arch Otolaryngol Head Neck Surg. 1995;121:1351-1354)