Microdebrider-Assisted Supraglottoplasty for Laryngomalacia

Objectives We describe our series in the surgical treatment of laryngomalacia using a microdebrider. Methods We performed a retrospective review of patients who underwent microdebrider-assisted supraglottoplasty for laryngomalacia between October 2004 and February 2008. Patients with neurologic conditions and secondary airway lesions were excluded. The main outcome measures included complications, pain, resolution of stridor, presence of aspiration, and need for revision surgery. Results Twenty-eight patients underwent microdebrider-assisted supraglottoplasty. The mean age at diagnosis was 109 days, and the mean age at the time of the procedure was 182 days. Nineteen patients (68%) had gastroesophageal reflux at diagnosis. The average operative time was 35.7 minutes (range, 11 to 65 minutes). No intraoperative complications or device problems occurred. Two patients remained intubated after the procedure. One patient required a tracheotomy, and 1 patient underwent revision supraglottoplasty. Three patients had aspiration that resolved. There was negligible pain from the procedure, as all patients immediately resumed a diet. All patients had immediate or eventual resolution of stridor. Conclusions This is the largest series of patients who underwent microdebrider-assisted supraglottoplasty for laryngomalacia. This procedure is relatively safe, with minimal pain, and effective in patients with laryngomalacia. Microdebrider-assisted supraglottoplasty is the method of choice for supraglottoplasty in our institution.

[1]  L. Holinger,et al.  Aspiration following CO(2) laser-assisted supraglottoplasty. , 2008, International journal of pediatric otorhinolaryngology.

[2]  R. Metson,et al.  Microdebrider eustachian tuboplasty: A preliminary report , 2007, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[3]  William O. Collins,et al.  Microdebrider-assisted supraglottoplasty. , 2005, International journal of pediatric otorhinolaryngology.

[4]  S. Schraff,et al.  American Society of Pediatric Otolaryngology members' experience with recurrent respiratory papillomatosis and the use of adjuvant therapy. , 2004, Archives of otolaryngology--head & neck surgery.

[5]  F. Denoyelle,et al.  Failures and complications of supraglottoplasty in children. , 2003, Archives of otolaryngology--head & neck surgery.

[6]  M. Francois,et al.  Transnasal endoscopic treatment of choanal atresia without prolonged stenting. , 2002, Archives of otolaryngology--head & neck surgery.

[7]  E. Mascha,et al.  Intracapsular Partial Tonsillectomy for Tonsillar Hypertrophy in Children , 2002, The Laryngoscope.

[8]  G. Zalzal,et al.  Powered instrumentation in the treatment of recurrent respiratory papillomatosis: an alternative to the carbon dioxide laser. , 2002, Archives of otolaryngology--head & neck surgery.

[9]  N. Bauman,et al.  Laryngomalacia and Its Treatment , 1999, The Laryngoscope.

[10]  D. Caldarelli,et al.  A Safe, Alternative Technique for Inferior Turbinate Reduction , 1999, The Laryngoscope.

[11]  E. Yanagisawa,et al.  Endoscopic Adenoidectomy with the Microdebrider , 1997, Ear, nose, & throat journal.

[12]  J. Krouse,et al.  Powered Instrumentation in Functional Endoscopic Sinus Surgery I: Surgical Technique , 1996, Ear, nose, & throat journal.

[13]  J. Anon,et al.  Epiglottoplasty for the Treatment of Laryngomalacia , 1987, The Annals of otology, rhinology, and laryngology.

[14]  A. Seid,et al.  Laser division of the aryepiglottic folds for severe laryngomalacia. , 1985, International journal of pediatric otorhinolaryngology.

[15]  L. Holinger,et al.  Etiology of Stridor in the Neonate, Infant and Child , 1980, The Annals of otology, rhinology, and laryngology.

[16]  S. Iglauer.  EPIGLOTTIDECTOMY FOR THE RELIEF OF CONGENITAL LARYNGEAL STRIDOR, WITH REPORT OF A CASE , 1922 .