Unilateral endoscopic supraglottoplasty for severe laryngomalacia.

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.