title: Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta-analysis.
abstract: To determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve following isolated supraglottoplasty for laryngomalacia with obstructive sleep apnea (OSA) in children.
  
  
  
  Systematic review and meta-analysis.
  
  
  
  Nine databases, including PubMed/MEDLINE, were searched through September 30, 2015.
  
  
  
  A total of 517 studies were screened; 57 were reviewed; and 13 met criteria. One hundred thirty-eight patients were included (age range: 1 month-12.6 years). Sixty-four patients had sleep exclusive laryngomalacia, and in these patients: 1) AHI decreased from a mean (M) ± standard deviation (SD) of 14.0 ± 16.5 (95% confidence interval [CI] 10.0, 18.0) to 3.3 ± 4.0 (95% CI 2.4, 4.4) events/hour (relative reduction: 76.4% [95% CI 53.6, 106.4]); 2) LSAT improved from a M ± SD of 84.8 ± 8.4% (95% CI 82.8, 86.8) to 87.6 ± 4.4% (95% CI 86.6, 88.8); 3) standardized mean differences (SMD) demonstrated a small effect for LSAT and a large effect for AHI; and 4) cure (AHI < 1 event/hour) was 10.5% (19 patients with individual data). Seventy-four patients had congenital laryngomalacia, and in these patients: 1) AHI decreased from a M ± SD of 20.4 ± 23.9 (95% CI 12.8, 28.0) to 4.0 ± 4.5 (95% CI 2.6, 5.4) events/hour (relative reduction: 80.4% [95% CI 46.6, 107.4]); 2) LSAT improved from a M ± SD of 74.5 ± 11.9% (95% CI 70.9, 78.1) to 88.4 ± 6.6% (95% CI 86.4, 90.4); 3) SMD demonstrated a large effect for both AHI and LSAT; and 4) cure was 26.5% (38 patients with individual data).
  
  
  
  Supraglottoplasty has improved AHI and LSAT in children with OSA and either sleep exclusive laryngomalacia or congenital laryngomalacia; however, the majority of them are not cured. Laryngoscope, 126:1246-1255, 2016.
authors.affiliation: Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii.|Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford Hospital and Clinics, Stanford, California, U.S.A.
authors.forename: Macario
authors.initials: M
authors.lastname: Camacho
authors.affiliation: John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.
authors.forename: Brandyn
authors.initials: B
authors.lastname: Dunn
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Stanford Hospital and Clinics, Stanford, California, U.S.A.
authors.forename: Carlos
authors.initials: C
authors.lastname: Torre
authors.affiliation: John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.
authors.forename: Jodie
authors.initials: J
authors.lastname: Sasaki
authors.affiliation: Department of Otorhinolaryngology/Sleep Medicine Centre-Hospital CUF, University of Porto, Porto, Portugal.
authors.forename: Raymond
authors.initials: R
authors.lastname: Gonzales
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of California San Francisco, San Francisco, California, U.S.A.
authors.forename: Stanley Yung-Chuan
authors.initials: SY
authors.lastname: Liu
authors.affiliation: School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A.
authors.forename: Dylan K
authors.initials: DK
authors.lastname: Chan
authors.affiliation: CINTESIS-Centre for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal.
authors.forename: Victor
authors.initials: V
authors.lastname: Certal
authors.affiliation: Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Cable
mesh_terms: D002648:Child; D005931:Glottis / Q000601:surgery; D006801:Humans; D007821:Laryngeal Muscles / Q000601:surgery*; D055092:Laryngomalacia / Q000150:complications / Q000601:surgery*; D010100:Oxygen / Q000097:blood; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D010100:Oxygen
keywords: Obstructive sleep apnea; laryngomalacia; meta-analysis; supraglottoplasty; systematic review