title: Supraglottoplasty for occult laryngomalacia to improve obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  To evaluate the polysomnographic outcomes after supraglottoplasty (SGP) performed for obstructive sleep apnea syndrome (OSAS) associated with occult laryngomalacia.
  
  
  METHODS
  Retrospective case series with medical chart review.
  
  
  METHODS
  Tertiary pediatric medical center.
  
  
  METHODS
  Twenty-two patients aged 2 to 17 years met the inclusion criteria of polysomnography-proven OSAS and occult laryngomalacia seen on flexible fiber-optic sleep endoscopy. Infants with congenital laryngomalacia were excluded.
  
  
  METHODS
  Carbon dioxide laser SGP was performed either alone or in conjunction with other operations for OSAS.
  
  
  METHODS
  Preoperative and postoperative nocturnal polysomnographic data were paired and analyzed statistically.
  
  
  RESULTS
  Supraglottoplasty for occult laryngomalacia resulted in statistically significant reduction in the apnea-hypopnea index (AHI) (from 15.4 to 5.4) (P <.001). Subgroup analysis of children who underwent either SGP alone or in combination with other interventions showed comparable reductions in AHI. Medical comorbidities were associated with worsened postoperative outcomes, although still significantly improved compared with baseline. Overall, 91% of children had an improvement in AHI, and 64% had only mild or no residual OSAS after SGP.
  
  
  CONCLUSIONS
  Supraglottoplasty is an effective technique for the treatment of OSAS associated with occult laryngomalacia.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, Stanford University School of Medicine, CA, USA. dylan.k.chan@gmail.com
authors.forename: Dylan K
authors.initials: DK
authors.lastname: Chan
authors.forename: Mai Thy
authors.initials: MT
authors.lastname: Truong
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koltai
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications / Q000601:surgery*; D053685:Laser Therapy / Q000295:instrumentation*; D054020:Lasers, Gas; D008297:Male; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome