title: Treatment outcome of supraglottoplasty vs. wait-and-see policy in patients with laryngomalacia.
abstract: In most cases, laryngomalacia presents as a mild disease, and the symptoms resolve after wait-and-see policy. Up to 20 % of patients present with severe laryngomalacia and may require surgery (i.e. supraglottoplasty); however, the indication for surgery is not firmly established yet. The goal of this study is to determine whether supraglottoplasty results in a better outcome than wait-and-see and to investigate how different comorbidities influence outcome. A retrospective study of pediatric cases of in a tertiary referral center was performed. Photo and video documentation was available and revised in all cases. Electronic and paper charts were reviewed for the following variables: gender, sex, gestational age, birth weight, symptoms, comorbidity, date of endoscopy, severity and type of laryngomalacia, treatment modality and technique and follow-up data and a total 89 patients were included. Supraglottoplasty was found to lead to significantly faster complete improvement of laryngomalacia than wait-and-see policy (5 weeks vs. 29, p = 0.026). Synchronous airway lesions (SALs) were present in 40.4 % of patients and were associated with prolonged symptoms of laryngomalacia (38.5 weeks vs. 14.5, p = 0.043). Supraglottoplasty is safe and effective in treatment of severe laryngomalacia. SALs and comorbidities are frequently found in patients with laryngomalacia and are responsible for longer onset of complaints.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.|Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: van der Heijden
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Frederik G
authors.initials: FG
authors.lastname: Dikkers
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. g.b.halmos@umcg.nl.
authors.forename: Gyorgy B
authors.initials: GB
authors.lastname: Halmos
mesh_terms: D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005865:Gestational Age; D005931:Glottis / Q000601:surgery; D006801:Humans; D007223:Infant; D055092:Laryngomalacia / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D057832:Watchful Waiting
keywords: Laryngomalacia; Supraglottoplasty; Synchronous airway lesions; Wait-and-see