Evaluation of the Efficacy of Supraglottoplasty in Obstructive Sleep Apnea Syndrome Associated With Severe Laryngomalacia


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Abstract

ObjectiveTo evaluate the clinical and polysomnographic evolution of patients with severe laryngomalacia who underwent supraglottoplasty.DesignRetrospective study.SettingUniversity hospital.PatientsSeven children with severe laryngomalacia.Main Outcome MeasuresThe patients were evaluated with a questionnaire given to their parents and with polysomnographic examination before and 3 months after surgery. The clinical data of respiratory and swallowing symptoms as well as the parameters of minimum oxygen saturation and respiratory disturbance index were evaluated after bilateral supraglottoplasty and compared with the preoperative data.ResultsTwo patients had pharyngolaryngomalacia and required tracheotomy. Four patients had a marked improvement of respiratory and deglutition symptoms. Polysomnographic data showed a significant improvement in the respiratory disturbance index after surgery (P<.05) but not in the minimum oxygen saturation level. However, this improvement was only partially achieved in 3 patients, in whom there were associated airway or neurologic changes. No serious surgical complications were observed.ConclusionSupraglottoplasty led to a marked improvement in all 5 patients without pharyngolaryngomalacia, but the 2 patients with pharyngolaryngomalacia required tracheotomy.

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