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Françoise Denoyelle, MD, PhD; Michel Mondain, MD, PhD; Nicolas Grésillon, MD; Gilles Roger, MD; Franck Chaudré, MD; Erea Noël Garabédian, MD

Arch Otolaryngol Head Neck Surg. 2003;129:1077-1080.

Objectives  To study the failures and complications of bilateral supraglottoplasty in children with severe laryngomalacia and to compare children with isolated laryngomalacia (IL) with those who have additional congenital anomalies (ACAs).

Design  Retrospective medical record review.

Setting  Two tertiary referral centers.

Subjects  A total of 136 consecutive patients, aged 3 days to 60 months (median age, 3 months) who underwent laser or instrumental bilateral supraglottoplasty. Isolated laryngomalacia occurred in 102 children, aged 3 days to 19 months; ACAs were found in 34 children, aged 3 weeks to 60 months.

Outcome Measures  Persistence of dyspnea, sleep apnea, and/or failure to thrive; need for further treatment; minor complications (defined as granuloma, edema, or small web); or major complication (supraglottic stenosis).

Results  Failures or partial improvement were observed in 12 (8.8%) of 136 cases, all having ACAs. The overall rate of complications was 7.4% (10/136). There were no significant differences between the IL and ACA groups concerning the rate of recurrence needing revision surgery (3/102, 2.9% vs 3/34, 9%), the rate of minor complications (4/102, 3.9% vs 1/34, 3%), or the rate of supraglottic stenosis (4/102, 3.9% vs 1/34, 3%). Supraglottic stenosis was managed by revision surgery in 4 cases and/or noninvasive ventilatory assistance in 2 cases. The long-term outcome appeared to be better when reintervention could be avoided or was kept to a minimum.

Conclusion  Failure of supraglottoplasty was only observed in cases of laryngomalacia with ACAs. The complication rate was similar whether or not ACAs were present.

From the Services d'Otorhinolaryngologie Pédiatrique et de Chirurgie Cervicofaciale, Hôpital d'Enfants Armand-Trousseau, Paris (Drs Denoyelle, Roger, Chaudré, and Garabédian), and Otorhinolaryngologie, Hôpital Gui de Chauliac, Montpellier (Drs Mondain and Grésillon), France. The authors have no relevant financial interest in this article.

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