A systematic review of supraglottoplasty outcomes.
OBJECTIVE
To analyze the available published data on supraglottoplasty, epiglottoplasty, and laryngomalacia and to evaluate the relative risk of supraglottoplasty failure.


METHODS
Systematic review with determination of relative risk.


METHODS
A PubMed search was performed with the following inclusion criteria: English language, human subjects, supraglottoplasty, epiglottoplasty, and laryngomalacia. The results of the included studies were summarized and analyzed. Subgroup analysis was then performed.


RESULTS
Twelve studies were identified, with 8 meeting the inclusion criteria. The overall risk ratio of surgical failure among patients with associated comorbidities compared with those with isolated laryngomalacia was 7.14 (k = 6 studies; 95% CI, 3.73-13.74; P < .001). The risk ratio for persistent or significant aspiration after supraglottoplasty among patients with associated comorbidities compared with those with isolated laryngomalacia was 4.33 (k = 3 studies; 95% CI, 1.25-15.06; P = .02). Insufficient data were available to assess outcome by age at surgery or specific technique used.


CONCLUSIONS
The relative risk of supraglottoplasty failure is significantly higher among patients with associated medical comorbidities. This aggregate finding should be taken into account when parents are counseled as to the expected surgical outcome of infants with laryngomalacia who are undergoing supraglottoplasty.
Division of Otolaryngology, Children’s National Medical Center, 111 Michigan Ave NW, Washington, DC 20010, USA. dpreciad@cnmc.org
Diego
D
Preciado
George
G
Zalzal
D015897:Comorbidity; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007223:Infant; D055092:Laryngomalacia / Q000151:congenital / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome