Department of Otolaryngology, University of Colorado Health Sciences Center, Aurora, Colorado, USA.
Otolaryngol Head Neck Surg. 2011 Nov;145(5):818-22. doi: 10.1177/0194599811414513. Epub 2011 Jul 11.
Review the impact of bilateral supraglottoplasty on feeding and compare the risk of postoperative feeding difficulties between infants with and without additional comorbidities.
Case series with chart review.
Children's hospital.
The medical records of all patients between birth and 12 months of age treated for laryngomalacia with bilateral supraglottoplasty by a single surgeon (GPD) between December 2005 and September 2009 and followed for a minimum of 1 month were reviewed. Infants with significant comorbidities were evaluated separately. Nutritional intake before and after surgery, as well as speech and language pathology reports, was reviewed to qualify any feeding difficulties. Age at the time of surgery, additional surgical interventions, medical comorbidities, and length of follow-up were also noted during chart review.
Of 81 infants who underwent bilateral supraglottoplasty, 75 were eligible for this review. In the cohort of infants without comorbidities, 46 of 48 (96%) had no change or an improvement in their oral intake after surgery. Of the 2 patients with initial worsening of feeding, all resumed oral intake within 2 months. In the group of patients with additional medical comorbidities, 22% required further interventions such as nasogastric tube, dietary modification, or gastrostomy tube placement.
Supraglottoplasty in infants has a low incidence of persistent postoperative dysphagia. Infants with additional comorbidities are at a higher risk of feeding difficulty than otherwise healthy infants.
回顾双侧杓状软骨切除术对喂养的影响，并比较有无其他合并症的婴儿术后发生喂养困难的风险。
病例系列，回顾性研究。
儿童医院。
对 2005 年 12 月至 2009 年 9 月间由同一位外科医生（GPD）行双侧杓状软骨切除术治疗的所有婴儿（出生至 12 个月龄）的病历进行回顾性研究。这些婴儿至少随访 1 个月。严重合并症的婴儿单独评估。评估术前和术后的营养摄入情况，以及言语病理学报告，以明确任何喂养困难。在病历回顾期间还记录了手术时的年龄、其他手术干预、合并症和随访时间。
在 81 例行双侧杓状软骨切除术的婴儿中，有 75 例符合本研究纳入标准。在无合并症的婴儿队列中，48 例中有 46 例（96%）术后口腔摄入无变化或改善。2 例初始喂养恶化的婴儿，均在 2 个月内恢复经口摄入。在有其他合并症的婴儿组中，22%需要进一步干预，如鼻胃管、饮食调整或胃造口管放置。
婴儿杓状软骨切除术术后持续性吞咽困难的发生率较低。有其他合并症的婴儿比健康婴儿更有可能出现喂养困难。
