title: Supraglottoplasty for sleep endoscopy diagnosed sleep dependent laryngomalacia.
abstract: OBJECTIVE
  To evaluate the polysomnographic outcomes of supraglottoplasty (SGP) performed for sleep endoscopy diagnosed sleep dependent laryngomalacia as treatment for obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  Nine subjects aged 6-55 months underwent supraglottoplasty for sleep dependent laryngomalacia. All subjects underwent both pre- and post-procedural polysomnograms.
  
  
  RESULTS
  Supraglottoplasty for sleep dependent laryngomalacia resulted in improvement of OSAS as measured by collective improvements in 8 different primary polysomnogram parameters: apnea-hypopnea index (AHI), minimum (nadir) and mean oxygen saturation, mean and maximum carbon dioxide, total sleep time, sleep efficiency, arousal index, as well as improvement in weight for length percentiles. Subjects had a significant 80% decrease in percentage change in AHI (p<0.005), with decrease in mean AHI from 23.4 to 4.8 following supraglottoplasty. Seven of 9 subjects demonstrated improvement in nadir saturations, 6 of 9 subjects had improvement in sleep efficiency, and 7 of 8 subjects under 4 years of age had improvement in weight for length percentile.
  
  
  CONCLUSIONS
  Supraglottoplasty for sleep dependent laryngomalacia is an effective treatment of OSAS, and can be readily diagnosed using sleep endoscopy. Further investigation is warranted to increase awareness and outcomes related to sleep dependent laryngomalacia.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, United States.
authors.forename: Caitlin A
authors.initials: CA
authors.lastname: Mase
authors.affiliation: Division of Pediatric Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, WA, United States.
authors.forename: Maida L
authors.initials: ML
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, United States; Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, WA, United States.
authors.forename: David L
authors.initials: DL
authors.lastname: Horn
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, United States; Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, WA, United States. Electronic address: sanjay.parikh@seattlechildrens.org.
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Parikh
mesh_terms: D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007817:Laryngeal Cartilages / Q000601:surgery; D055092:Laryngomalacia / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: AHI; Obstructive sleep apnea syndrome; Polysomnography; Sleep dependent laryngomalacia; Sleep endoscopy; Supraglottoplasty