title: Evaluation of the efficacy of supraglottoplasty in obstructive sleep apnea syndrome associated with severe laryngomalacia.
abstract: OBJECTIVE
  To evaluate the clinical and polysomnographic evolution of patients with severe laryngomalacia who underwent supraglottoplasty.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Seven children with severe laryngomalacia.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Two 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.
  
  
  CONCLUSIONS
  Supraglottoplasty led to a marked improvement in all 5 patients without pharyngolaryngomalacia, but the 2 patients with pharyngolaryngomalacia required tracheotomy.
authors.affiliation: Department of Ophthalmology, University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. facpvalera@uol.com.br
authors.forename: Fabiana Cardoso Pereira
authors.initials: FC
authors.lastname: Valera
authors.forename: Edwin
authors.initials: E
authors.lastname: Tamashiro
authors.forename: Marcos M
authors.initials: MM
authors.lastname: de Araújo
authors.forename: Heidi H
authors.initials: HH
authors.lastname: Sander
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Küpper
mesh_terms: D001193:Arytenoid Cartilage / Q000601:surgery; D002357:Cartilage Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D004825:Epiglottis / Q000601:surgery; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007817:Laryngeal Cartilages / Q000601:surgery; D007818:Laryngeal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*