Sabran B, Ghelab Z, Bois E, Chebib E, Levivien S, Kahn L, Bellanger S, Abbeele T Van Den, Teissier N, Benoit C
Department of Otolaryngology, Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP) and Paris University, 48, Boulevard Sérurier, 75019, Paris, France.
Ear, Nose & Throat, Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, 26 Rue d'Ulm, 75005, Paris, France.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1971-1980. doi: 10.1007/s00405-024-09172-0. Epub 2025 Jan 14.
This study aimed to identify factors predicting postoperative ICU admission, the need for orotracheal intubation (OTI), and the occurrence of supraglottic stenosis in children undergoing supraglottoplasty for laryngomalacia.
A retrospective analysis was conducted on 31 children who underwent supraglottoplasty at Robert Debre University Hospital from February 2016 to June 2023. Patient demographics, medical history, pre- and postoperative findings, and outcomes were evaluated. Statistical analyses were performed using R software.
A total of 60% of patients required ICU admission postoperatively. Factors predictive of ICU admission included a history of genetic anomalies, younger age at surgery, poor weight gain, and preoperative enteral feeding. Among those requiring OTI, significant predictors included a history of neurological disease, abnormal vocal cord mobility, and intraoperative arterial oxygen saturation dropping below 90%. Two patients developed supraglottic stenosis, with a noted correlation to surgical technique and preoperative respiratory severity.
While supraglottoplasty is generally safe and effective, specific factors can predict the need for postoperative ICU care and intubation. The findings highlight the importance of thorough preoperative assessments and optimization of gastroesophageal reflux management to mitigate complications.
本研究旨在确定预测行喉软化症声门上成形术儿童术后入住重症监护病房（ICU）、需要进行气管插管（OTI）以及声门上狭窄发生情况的因素。
对2016年2月至2023年6月在罗伯特·德布雷大学医院接受声门上成形术的31例儿童进行回顾性分析。评估患者的人口统计学资料、病史、术前和术后检查结果以及预后。使用R软件进行统计分析。
共有60%的患者术后需要入住ICU。预测入住ICU的因素包括遗传异常病史、手术时年龄较小、体重增加不佳以及术前肠内喂养。在需要进行气管插管的患者中，显著的预测因素包括神经疾病病史、声带活动异常以及术中动脉血氧饱和度降至90%以下。两名患者发生了声门上狭窄，与手术技术和术前呼吸严重程度存在明显关联。
虽然声门上成形术总体上安全有效，但特定因素可预测术后ICU护理和插管的需求。研究结果强调了全面术前评估和优化胃食管反流管理以减轻并发症的重要性。
