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A novel technique for unilateral supraglottoplasty.

Abstract Traditional supraglottoplasty for pediatric laryngomalacia is most commonly conducted with either CO2 laser or cold steel instruments. While the procedure enjoys high success rates, serious complications such as excessive bleeding, supraglottic stenosis and aspiration can occur. Unilateral coblation supraglottoplasty may reduce this risk, but data on respiratory and swallowing outcomes are lacking. This study reports our experiences with unilateral coblation supraglottoplasty.
PMID
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Authors

Mayor MeshTerms
Keywords

Congenital laryngomalacia

Pediatric airway

Supraglottoplasty

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 29287857
OWN - NLM
STAT- MEDLINE
DCOM- 20180116
LR  - 20180116
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 104
DP  - 2018 Jan
TI  - A novel technique for unilateral supraglottoplasty.
PG  - 150-154
LID - S0165-5876(17)30546-3 [pii]
LID - 10.1016/j.ijporl.2017.11.003 [doi]
AB  - OBJECTIVES: Traditional supraglottoplasty for pediatric laryngomalacia is most
      commonly conducted with either CO2 laser or cold steel instruments. While the
      procedure enjoys high success rates, serious complications such as excessive
      bleeding, supraglottic stenosis and aspiration can occur. Unilateral coblation
      supraglottoplasty may reduce this risk, but data on respiratory and swallowing
      outcomes are lacking. This study reports our experiences with unilateral
      coblation supraglottoplasty. METHODS: Pediatric patients with severe congenital
      laryngomalacia who underwent unilateral supraglottoplasty at a single institution
      from 2013 to 2016 were retrospectively reviewed. Bipolar radiofrequency ablation 
      (Coblation) was utilized with partial arytenoidectomy, aryepiglottoplasty, and
      advancement of mucosal flaps. Outcome measures included apnea-hypopnea index
      (AHI), weight-by-age percentile, and decannulation rate. RESULTS: Twelve patients
      were included with an average age of 13.1 months (range 2-28 months). In patients
      without tracheostomy, 88% had complete resolution of respiratory symptoms, while 
      the remainder had significant improvement. In patients without gastrostomy tubes,
      there was an average increase in weight-age percentile of 6.1, 7.8, and 15.3
      points at 1, 3, and 6 months postoperatively, respectively. Three patients had
      complete polysomnography data with a mean preoperative AHI of 19.3 and
      postoperative AHI of 4.0. Three of four patients with tracheostomy have been
      decannulated at a mean follow-up of 1.5 years. There were no early or late
      postoperative complications and no revision supraglottoplasty. CONCLUSION:
      Unilateral supraglottoplasty with bipolar radiofrequency ablation can improve
      respiratory symptoms and decrease OSA severity in severe congenital
      laryngomalacia. This technique is safe and can lead to substantial improvement in
      AHI in patients with OSA.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Ching, Harry H
AU  - Ching HH
AD  - Department of Otolaryngology - Head and Neck Surgery, University of Nevada Las
      Vegas School of Medicine, 1701 W. Charleston Blvd., Suite #490, Las Vegas, NV
      89102, USA. Electronic address: [email protected]
FAU - Spinner, Alycia G
AU  - Spinner AG
AD  - Department of Otolaryngology - Head and Neck Surgery, University of Nevada Las
      Vegas School of Medicine, 1701 W. Charleston Blvd., Suite #490, Las Vegas, NV
      89102, USA. Electronic address: [email protected]
FAU - Reeve, Nathaniel H
AU  - Reeve NH
AD  - Department of Otolaryngology - Head and Neck Surgery, University of Nevada Las
      Vegas School of Medicine, 1701 W. Charleston Blvd., Suite #490, Las Vegas, NV
      89102, USA. Electronic address: [email protected]
FAU - O-Lee, T J
AU  - O-Lee TJ
AD  - Department of Otolaryngology - Head and Neck Surgery, University of Nevada Las
      Vegas School of Medicine, 1701 W. Charleston Blvd., Suite #490, Las Vegas, NV
      89102, USA. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20171106
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
SB  - IM
MH  - Catheter Ablation/adverse effects/*methods
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Laryngomalacia/congenital/*surgery
MH  - Laryngoplasty/adverse effects/*methods
MH  - Male
MH  - Postoperative Complications/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Congenital laryngomalacia
OT  - Pediatric airway
OT  - Supraglottoplasty
EDAT- 2017/12/31 06:00
MHDA- 2018/01/18 06:00
CRDT- 2017/12/31 06:00
PHST- 2017/09/12 00:00 [received]
PHST- 2017/11/02 00:00 [revised]
PHST- 2017/11/03 00:00 [accepted]
PHST- 2017/12/31 06:00 [entrez]
PHST- 2017/12/31 06:00 [pubmed]
PHST- 2018/01/18 06:00 [medline]
AID - S0165-5876(17)30546-3 [pii]
AID - 10.1016/j.ijporl.2017.11.003 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2018 Jan;104:150-154. doi:
      10.1016/j.ijporl.2017.11.003. Epub 2017 Nov 6.