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Supraglottoplasty in neonates and infants: A radiofrequency ablation approach.

Abstract Supraglottoplasty is the mainstay of surgical treatment for laryngomalacia. A novel supraglottoplasty surgical technique is needed to achieve better efficacy. The purpose of this study was to introduce modified microscopic radiofrequency ablation supraglottoplasty (MMRAS) for the treatment of congenital laryngomalacia and to evaluate the outcome and effectiveness of this novel approach.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29443747
OWN - NLM
STAT- MEDLINE
DCOM- 20180222
LR  - 20180222
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 7
DP  - 2018 Feb
TI  - Supraglottoplasty in neonates and infants: A radiofrequency ablation approach.
PG  - e9850
LID - 10.1097/MD.0000000000009850 [doi]
AB  - BACKGROUND: Supraglottoplasty is the mainstay of surgical treatment for
      laryngomalacia. A novel supraglottoplasty surgical technique is needed to achieve
      better efficacy. The purpose of this study was to introduce modified microscopic 
      radiofrequency ablation supraglottoplasty (MMRAS) for the treatment of congenital
      laryngomalacia and to evaluate the outcome and effectiveness of this novel
      approach. METHODS: Seventeen children with severe laryngomalacia who underwent
      MMRAS were studied retrospectively. Supraglottoplasty of type III laryngomalacia 
      was different from classical method. All the patients were kept intubated for 5
      days after surgery to achieve a better epiglottal position and to avoid
      reconglutination of aryepiglottic folds. The patients' demographic information,
      symptoms, comorbidities, type of laryngomalacia, synchronous airway lesions and
      final outcomes were examined. RESULTS: The median age at the time of surgery was 
      3.36 months (3 months 10 days). Operative indications included feeding
      difficulties, noisy breathing or respiratory distress (or both), and
      sleep-related symptoms. The MMRAS success rate was 82.4%. Most patients were
      extubated successfully on postoperative day 5. The major postoperative
      complication was pulmonary infection which occurred in 3 cases (17.6%) and
      required anti-infective therapy. No perioperative deaths and no long-term
      complications occurred. Failures were observed in 3 (17.6%) of 17 cases, 2
      patients presented with a neurological disease and required tracheostomy, 1
      patient relapsed because of postoperative adhesions and later underwent revision 
      supraglottoplasty. CONCLUSIONS: From these results, we conclude that MMRAS is an 
      effective and safe treatment for symptomatic laryngomalacia and has the potential
      to provide better breathing, feeding, and sleeping outcomes in children with
      severe laryngomalacia. Postoperative intubation for 5 days may result in better
      therapeutic outcomes. Multicenter cooperative studies of comparison between MMRAS
      and conventional approaches would lend further evidence-based support for this
      surgical method.
FAU - Pu, Shilei
AU  - Pu S
AD  - Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital,
      Shanghai Jiao Tong University, Shanghai, People's Republic of China.
FAU - Xu, Hongming
AU  - Xu H
FAU - Li, Xiaoyan
AU  - Li X
LA  - eng
PT  - Evaluation Studies
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Catheter Ablation/*methods
MH  - Epiglottis/*surgery
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Laryngomalacia/*surgery
MH  - Male
MH  - Microsurgery/*methods
MH  - Reconstructive Surgical Procedures/*methods
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2018/02/15 06:00
MHDA- 2018/02/23 06:00
CRDT- 2018/02/15 06:00
PHST- 2018/02/15 06:00 [entrez]
PHST- 2018/02/15 06:00 [pubmed]
PHST- 2018/02/23 06:00 [medline]
AID - 10.1097/MD.0000000000009850 [doi]
AID - 00005792-201802160-00021 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(7):e9850. doi: 10.1097/MD.0000000000009850.