title: Supraglottoplasty for laryngomalacia with obstructive sleep apnea.
abstract: OBJECTIVE
  To determine if supraglottoplasty (SGP) is effective in reversing abnormal respiratory parameters in children with laryngomalacia and obstructive sleep apnea (OSA).
  
  
  METHODS
  Retrospective case series at a tertiary referral children's hospital.
  
  
  METHODS
  Ten patients with laryngomalacia and OSA as documented by polysomnography underwent SGP between 2005 and 2007. Data collected included age, findings on flexible and rigid endoscopy, type of procedure performed, and postoperative course. The postoperative polysomnographies were reviewed to identify changes in obstructive apnea index, obstructive apnea/hypopnea index, respiratory disturbance index, and low arterial oxygen saturation (O2 nadir) after SGP.
  
  
  RESULTS
  All 10 patients were successfully extubated after SGP. There were no peri- or postoperative complications, and no patient required a subsequent airway procedure. Each patient had a postoperative nocturnal polysomnography performed after SGP at 11 weeks (range 2-29 weeks). Caregivers reported mild improvement (10%), significant improvement (70%), and complete resolution (20%) of stridor and nocturnal snoring at a follow-up visit 4 weeks after discharge. Marked improvements were observed in obstructive apnea index, obstructive apnea/hypopnea index, respiratory disturbance index and O2 nadir, all of which were statistically significant (P < .05).
  
  
  CONCLUSIONS
  Polysomnography should be considered in the initial evaluation of infants with moderate laryngomalacia to rule out OSA. SGP is an effective treatment for infants with laryngomalacia and OSA. The significant benefits of the procedure outweigh thelow morbidity. Improvement after surgery was reliably confirmed by polysomnography in this study.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The University of Texas-Houston Health Science Center, Houston, Texas, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Zafereo
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Taylor
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Pereira
mesh_terms: D004724:Endoscopy; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*