SEARCH · PubMed Health

Results for “Supraglottitis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

PubMed2001

Management of cancer of the supraglottis.

We present the results of a retrospective study of 903 patients treated with conservation surgery for carcinoma of the supraglottic larynx so we can evaluate our management of supraglottic cancer with different types of surgery. In 301 patients, an extended supraglottic laryngectomy was performed. The recent selective use of transoral laser resection appears to be a rational approach. The 5-year uncorrected survival was 84%, 81%, 76%, and 55% for stages I, II, III, and IV, respectively. The most common site for local-regional failure was the cervical lymphatics. The percentage of occult disease in the NO neck was 21% and epilaryngeal supraglottic location, locally advanced and GIII tumors have a higher frequency of lymph node involvement. There were no differences between comprehensive and anterolateral elective neck dissections. A bilateral elective neck dissection is recommended. In histologically positive neck disease, the survival rates were better with postoperative radiotherapy only in cases of extracapsular spread.

Carcinoma↗

PubMed2000

The role of partial laryngeal resection in current management of laryngeal cancer: a collective review.

A spectrum of treatment plans and surgical procedures is available for management of early and moderately advanced laryngeal cancer. While the approach of chemotherapy and irradiation, or irradiation alone, followed by total laryngectomy for failure is often employed in practice by present day clinicians, the options of conventional conservation surgery (CCS), transoral endoscopic laser surgery (TLS) and supracricoid partial laryngectomy (SCPL) provide a wide choice of treatments that may help attain the goal of cure with preservation of laryngeal function and integrity of the airway. While CCS has been supplanted for many early-stage lesions by TLS and for more advanced stages by SCPL, centres throughout the world have reported favourable results with CCS, which is often modified to include resection of more extensive tumours than was previously possible. During the past decade a number of extended CCS procedures have been developed for management of glottic tumours involving both vocal cords and the anterior commissure, the paraglottic space and with vocal cord fixation, and for supraglottic tumours involving the glottis or hypopharynx. TLS has proved an effective, minimally invasive and functionally satisfactory procedure for management of suitable T1 and T2 glottic cancers, and stage I-III supraglottic cancers. The procedure may be effectively employed in combination with neck dissection and postoperative radiotherapy when necessary, particularly for moderately advanced supraglottic carcinomas. SCPL has proven effective in management of glottic and supraglottic cancers of all stages, even with involvement of paraglottic space and thyroid cartilage, provided at least one arytenoid unit can be preserved with clear margins. Invasion of cricoid cartilage is the most significant limitation for this procedure. All three surgical approaches have been employed for irradiation failure, but with greatly increased failure and complication rates compared with the results of treatment of non-irradiated patients. Thus a decision to treat laryngeal cancer initially with irradiation may preclude a satisfactory result from partial laryngectomy should radiation fail. The treatment of laryngeal cancer should be individualized according to the size and extent of the tumour, the age and physical condition of the patient, and the skill and experience of the surgeon with various treatment modalities and surgical procedures.

Combined Modality Therapy↗

PubMed2001

Decreasing incidence and improved survival of laryngeal cancer in Finland.

The decreasing incidence rate and improvement in survival of laryngeal cancer patients in Finland are exceptions among western countries. A descriptive study of these trends was conducted including both nationwide population-based cancer registry data with 5 766 patients diagnosed in 1956-1995 and regional hospital-based data from Northern Finland, allowing classification into supraglottic and glottic cancers, with 353 patients diagnosed in 1976-1995. In Finland, the age-adjusted incidence rate among males decreased from 6.5 per 100 000 in 1956-1965 to 3.5 in 1986-1995, while in females the rate remained around 0.3 per 100 000. The rates in Northern Finland were slightly higher and the supraglottic to glottic incidence ratio diminished from 1.4:1 in 1976-1985 to 0.5:1 in 1986-1995. The 5-year relative survival rate improved in both Northern Finland and the whole country, most noticeably among males and the elderly. In the data from Northern Finland, the survival rate was more favourable in glottic (80%) than in supraglottic cancer (64%). Considering the marked decrease in the incidence of the less favourable supraglottic disease, the observed improvement in survival was small.

Adolescent↗

PubMed2000

A novel approach to laryngeal suspension after partial laryngectomy.

OBJECTIVES: Supraglottic laryngectomy is a well-established surgical therapy for selected carcinomas of the larynx and hypopharynx. Most compromised by this procedure and its variations is the laryngeal mechanism that protects the lower respiratory tract from aspiration. Laryngeal suspension serves to compensate for the loss of the resected laryngeal elevator muscles by pulling the larynx upward and forward beneath the tongue base. In this study we describe a method of laryngeal suspension in supraglottic laryngectomy using a cartilage-anchored suture carrier device. STUDY DESIGN: Report of this novel approach to laryngeal suspension using seven suture anchors in two patients undergoing supraglottic laryngectomy. METHODS: Seven Mitek Micro anchors (Mitek, Westwood, MA) were used to perform laryngeal suspension in two patients undergoing supraglottic laryngectomy. Our technique is compared with traditional methods. Operative data as well as postoperative functional results are reviewed. RESULTS: Laryngeal suspension using suture anchors was successful, with failure of only one anchor. Oral alimentation was quickly reestablished in both patients. There were no perioperative or postoperative complications. CONCLUSIONS: We describe a novel approach to laryngeal suspension that overcomes some of the technical challenges inherent in traditional suturing techniques. This novel approach is technically easier and more efficient than traditional methods and accomplishes distribution of stress forces on the thyroid cartilage remnant.

Carcinoma, Squamous Cell↗

PubMed2000

Treatment of laryngeal carcinomas by laser endoscopic microsurgery.

OBJECTIVES: To determine if laser endoscopic microsurgery is a reliable and appropriate approach in the treatment of laryngeal cancers. STUDY DESIGN: Retrospective study of 160 patients treated from 1988 to 1996 at Liège. Analysis of indication, technique, and oncologic results. METHODS: Glottic tumors were treated with either type I, type II, or type III cordectomy, with or without conservation of an inferior muscular band, and extended if necessary to all or part of the contralateral cord. For supraglottic cancers, an excision limited to a part of the vestibule, a trans-preepiglottic resection, or a radical supraglottic resection was carried out. RESULTS: Our corrected actuarial survival at 5 years was 97% for the 98 infiltrative glottic tumors and 100% for the 18 infiltrative supraglottic and 27 in situ carcinomas. No local recurrences were noted, in either the group of 118 infiltrating cancers (in whom two precancerous lesions were treated with a further laser excision), or in the 27 in situ carcinomas. Local control was thus 100%. One patient died of his cancer, with lung metastases after neck recurrence. CONCLUSIONS: Like Steiner and Rudert, this series demonstrates the oncologic validity of this surgical approach to the treatment of unadvanced glottic tumors. Unlike these authors' study, however, strict case selection, as in cases with significant involvement of the anterior commissure, has allowed us to avoid local recurrences and consequently to avoid salvage total laryngectomies. Our experience with supraglottic cancers is too small to confirm the oncologic validity of this type of surgery but seems promising.

Adult↗

PubMed1993

Upper airway obstruction induced by negative-pressure ventilation in awake healthy subjects.

Negative-pressure ventilation (NPV) induces sleep-related upper airway obstruction. However, the precise mechanism and site of upper airway obstruction during NPV have not been worked out. We studied seven awake healthy volunteers (23-30 yr old) in an Emerson tank respirator. Subjects had the head outside the iron lung and breathed through a pneumotachograph, which yielded the airflow (V) signal. Supraglottic pressure (Psg) was measured with a catheter with the tip at the retroepiglottic level. Diaphragmatic electromyograms (EMGdi) were obtained from an esophageal bipolar electrode. Tidal volume was measured with an inductance plethysmograph. Measurements were done at -10, -20, and -30 cmH2O. At each pressure run subjects were asked to repeatedly relax or to actively breathe in phase with the respirator. Subjects had been previously trained to relax during NPV. During the relax runs there was no EMGdi activity. Stridor or wheezing occurred in all seven subjects during the relax runs but not during the active runs. Two patterns were associated with NPV during relax runs. One pattern was decreases in both V and Psg followed by zero values of these indexes, which corresponded to an inspiratory narrowing and closure of the glottis. These changes were visualized by fiber-optic bronchoscopy in one subject. The second pattern was a decrease in V and increase in Psg, which corresponded to an inspiratory supraglottic obstruction. In five subjects a supraglottic pattern was observed, whereas in two subjects glottic closure was seen. We conclude that muscular relaxation during NPV produces a decrease in the caliber of the upper airways at the glottic or supraglottic level. An uncoupling of upper airway muscle activity and the diaphragm might be the mechanism responsible for these changes.

Adult↗

PubMedDate not supplied

Endoscopic surgical management for laryngomalacia. Case report and review of the literature.

Laryngomalacia is the most common of the many causes of respiratory stridor in the newborn. It may be identified by fiberoptic nasopharyngoscopy in the nursery or office. Several anatomic mechanisms of supraglottic collapse have been reported in the literature. The most common is a narrowing of the supraglottic airway with blockage of the glottic opening by the redundant tissue of the aryepiglottic folds. Although surgery rarely is indicated, severe airway obstruction, necessitating surgical intervention, can occur. Resection of supraglottic tissue should be performed only as an alternative to tracheotomy. Surgical procedures ranging from tracheotomy to epiglottidectomy have been advocated. Direct visualization of the obstructing tissue by nasopharyngoscopy allows the planning of an appropriate surgical procedure. In a patient with lateral supraglottic collapse, deep resection of the epiglottis would be expected to weaken the support of the aryepiglottic folds and aggravate the airway condition. Similarly, resection of tissue along the aryepiglottic folds will be useful only if preoperative evaluation demonstrates the obstruction to be at this location.

Airway Obstruction↗

PubMedDate not supplied

Development of congenital laryngeal atresias and clefts.

Congenital supraglottic laryngeal obstruction still is being described as subglottic stenosis. There are three clearly defined types of congenital laryngeal atresia, which result from arrest at consecutive developmental stages. Type 1 consists of a supraglottic obstruction, absent vestibule, and stenotic infraglottis, and type 2 is a supraglottic obstruction that separates a shallow primitive vestibule above from a nonstenotic infraglottis. These two types usually are accompanied by other defects, many of them severe. In type 3, a perforated membrane partly obstructs the glottis. Arrest of the dorsal advance of the chondrifying cricoid before the ends meet to form the dorsal lamina results in a complete laryngeal cleft, and incomplete fusion of the ends may leave a notch and/or foramen within the lamina. Failure of the interarytenoid tissue to develop will produce a local cleft, and maldevelopment of the cricoid cartilage or infraglottic submucosa can result in true subglottic stenosis without supraglottic obstruction.

Humans↗

PubMed1990

The adjustable supraglottiscope.

Transoral surgery in the supraglottic larynx is facilitated by the use of a new instrument, an adjustable supraglottiscope. Conventional adjustable laryngoscopes are not designed for supraglottic surgery and are therefore difficult to use in this area. The adjustable supraglottiscope: (1) provides wide exposure of the supraglottis and much of the lower pharynx, (2) allows instruments to be introduced from the side (between the blades), (3) allows for true suspension, and (4) retracts the endotracheal tube out of the way. These factors provide greater visualization and control of the surgical field and thus improve hemostasis and precision. The adjustable supraglottiscope has been used successfully in a variety of clinical situations. Transoral supraglottic surgery now takes considerably less time and is done with much greater ease. The adjustable supraglottiscope is a valuable instrument in our armamentarium and extends our versatility for endoscopic management of lesions of the supraglottic larynx and lower pharynx.

Glottis↗

PubMed1980

Results of conservation surgery for cancers of the supraglottis and pyriform sinus.

A retrospective review of patients treated by surgery and/or radiation for carcinoma of the supraglottic larynx and the pyriform sinus was accomplished for the period 1964-1974. This patient population reflects the 10-year period following earlier experience with conservation surgery at this institution, and, thus, updates the current status of treatment for these cancers. Endpoints examined included survival, control, pattern of failure, the influence of nodal metastasis, and voice preservation. Of 160 patients treated for supraglottic laryngeal carcinoma, 119 received conservation surgery (subtotal supraglottic laryngectomy, SSL, or partial laryngopharyngectomy, PLP); 21 patients received total laryngectomy; and 20 others received palliative radiation. The 3-year actuarial survivals for these groups were 67%, 43% and 30%, respectively. Voice was preserved in 85% of the patients treated by conservation surgery, in 70% of those treated by radiation alone, and, of course, in none of the patients receiving total laryngectomy. There were 175 patients treated for carcinoma of the pyriform sinus; 85 received PLP; 57, total laryngopharyngectomy (TLP); and 33, palliative radiation. Acturial 3-year survival was 59% for the PLP-treated group, 36% for the TLP-treated group and 11% for the palliation group. Voice was preserved in 52% of the patients treated by conservation surgery, in 6% of those treated by radiation alone, and in none of those patients treated by total laryngectomy. Comparison of this data with that in other published reports indicates that, for selected patients, conservation surgery is as effective in controlling disease as is radical surgery. Furthermore, it is possible to preserve speaking ability in a significant number of patients having carcinoma of the supraglottic larynx or pyriform sinus.

Carcinoma, Squamous Cell↗

PubMed2001

[Microscopic measurement of the surgical resection margins of laryngeal carcinomas].

OBJECTIVE: To investigate the relationship between the primary sites of laryngeal carcinomas and the surgical resection margins, to obtain quantitative data of the safe distance of surgical margins for supraglottic and glottic carcinomas. METHODS: In this series, 33 cases of surgical specimens of laryngeal carcinomas were examined and measured microscopically by means of cutting strips of tissues adjacent to the tumor and longitudinal serial sections. RESULTS: The pattern and extent of invasion of supraglottic carcinoma were quite different from those of glottic carcinoma. Under microscopic measurement, the tumor invasion distance in 95% of the supraglottic carcinoma samples was within 10.52 mm, while that of 95% of the glottic carcinoma samples was within 4.41 mm. CONCLUSIONS: The local invasion of laryngeal carcinomas appears to be primary tumor site-dependent. The safe distance of surgical resection margins may be set at 12.52 mm and 6.41 mm for supraglottic and glottic carcinomas, respectively.

Adult↗

PubMed2004

[The relationship between the surgical margin and local recurrence of laryngeal carcinoma].

OBJECTIVE: To study the relationship between the surgical margin and local recurrence of laryngeal carcinoma. METHOD: The surgical margin, T staging, postoperative irradiation and the local recurrence of 160 cases of laryngeal carcinoma operated between 1991 and 1999 were retrospectively reviewed and analyzed. RESULT: (1) Of 160 cases of laryngeal carcinoma, local recurrences were occurred in 36 cases (22.5%). (2) Local recurrence was statistically significantly related to the T staging of the tumor. (3) By comparing the local recurrence of 3 groups of patients: surgical margin < or = 3 mm, between 4-5 mm and > 5 mm, the rate of local recurrence of the group with surgical margin less than 3 mm were significantly higher than that of the groups with surgical margin between 4-5 mm and > 5 mm. (4) Of 69 cases with surgical margin less than 3 mm, 32 cases were received the postoperative irradiation, while 37 cases did not undergo. Statistical analysis showed that the local recurrence of the group of patients received postoperative irradiation was significantly lower than that of patients who did not received postoperative irradiation. (5) By analyzing the rate of local recurrence of difference surgical margin in the patients with glottic and supraglottic carcinoma, we found that the 5 mm as a surgical margin was relatively safe for the glottic carcinoma, but it was not the case for the supraglottic carcinoma. CONCLUSION: 5 mm as a surgical margin is relatively safe for the glottic carcinoma, but it is not the case for the supraglottic carcinoma. Therefore, the surgical margin more than 5 mm is proposed for supraglottic carcinoma. For the patients with surgical margin less than 3 mm, postoperative irradiation can effectively reduce the rate of local recurrence, but this does not mean that we can reduce the standard surgical margin during the laryngectomy.

Adult↗

PubMed2004

[Outcome of the treatment for laryngeal carcinoma by partial laryngectomies].

The aim of the study was to retrospectively evaluate the results of treatment for early laryngeal carcinoma in a group of 325 patients who underwent from 1980 to 1997 partial laryngectomies. The most often type of operation was cordectomy--51.1%, then frontolateral/frontoanterior laryngectomy--20.9%, vertical laryngectomy--15.1%, supraglottic horizontal laryngectomy--8%, hemilaryngectomy--4.9%. Estimate of survival time, from surgery to first oncologic failure, was obtained with the life-table method. As a failure we considered local and regional recurrence, distant metastasis, second primary neoplasm and spread of disease. The probability of disease-free survival for all partial laryngectomies reached 81.5%, 79.5% and 60.3% at 3, 5 and over 5 years, respectively. The rates of five-year and over 5 year disease-free survival for each type of operation were: for cordectomy--82.3% and 72.3%, for frontolateral/frontoanterior laryngectomy--74.0% and 45.2%, for vertical laryngectomy--87.6% and 60.6%, for hemilaryngectomy--86.2% and 59.7%, for supraglottic horizontal laryngectomy--53.8% and 29.9%, respectively. The comparison between survival rates, by the log-rank test, revealed statistical difference between supraglottic horizontal laryngectomy and following operations: cordectomy (p < 0.001), vertical laryngectomy (p < 0.01), hemilaryngectomy (p < 0.05). The differences between other types of laryngectomy were not significant statistically. The best results in treatment of laryngeal carcinoma by partial laryngectomies were achieved by operations in vertical plane (cordectomy, vertical laryngectomy and hemilaryngectomy), the less positive--by operations in horizontal plane (supraglottic horizontal laryngectomy).

Adult↗

PubMed1992

Radiotherapy of laryngeal cancer. General principles and results in T1 and T2 cases.

Radiotherapy is an effective treatment modality for early (T1-T2) laryngeal cancer, offering the patient a substantial chance of cure while preserving the anatomical integrity of the larynx. Whereas in early glottic lesions the irradiation volume can be restricted to the larynx proper, in supraglottic tumours the inclusion of the regional nodes is mandatory in view of their propensity for regional spread. Local control figures at 5 years are broadly in the range of 79% to 91% (T1) and 63% to 72% (T2) for glottic cancer and of about 75% (T1) and 50% (T2) for supraglottic cancer (N0 + N+). Net survival figures, including those patients having received salvage surgery are in the range of 80% to 98% (T1 glottic), of 60% to 90% (T2 glottic), of 82% to 100% (T1 supraglottic) and of 58% to 88% (T2 supraglottic).

Cobalt Radioisotopes↗

PubMed1996

Radical radiotherapy for T3 laryngeal cancers.

PURPOSE: Evaluation of the local control rate and voice preservation probability in radically irradiated patients with T3 laryngeal cancer. PATIENTS AND METHODS: From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. RESULTS: Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respectively. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. CONCLUSION: Current results indicated that initial radical radiotherapy and surgery for salvage might be an option for some patients with T3 laryngeal cancer.

Adult↗

PubMed1998

[Horizontal laryngectomy in treatment of laryngeal cancer--oncologic and function results].

The purpose of this paper was the retrospective evaluation of the results after horizontal partial larynx resection of different dimension. The material comprised 468 patients treated according to the described techniques in ENT Clinic Pom. Med. Acad. between 1970-1991. The series of patients subjected to analysis consisted of 35% of all cases treated by surgery and 70% of all conservative operations performed for cancer of the larynx in the above-mentioned period of time. Particulars were obtained from: a) case history, b) control examination, c) correspondence, d) data from USC. The results of the treatment in particular groups were submitted for detailed analysis. The assessment of applied technique from oncologic point of view was done on the basis of local recurrences and percentage of 3 and 5 years survival rate. Functional results were evaluated according to protective, respiratory and phonatory functions of the residual larynx. Results of the investigations were submitted for statistic valuation. In all types of operations satisfactory oncologic results were achieved. They were represented by high percentage of survival rate and low percentage of local recurrences. The longest survival 3- and 5-years respectively (73.90%) and 63.45%) and the lowest index of local failure (4.2%) were seen after classic, supraglottic resection. After horizontal glottic larynx resection 8/10 of patients operated on survived 3 years, 4/6 survived 5 years. Local recurrence was observed in 1/12 patients (Tab. 2). The lowest rate of survival (54.76% and 42.86%) and the highest number of local failures (11.3%) were revented after supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP)--in this group carcinomas staged T3 were predominant. After enlarged supraglottic laryngectomy and supracricoid resection with cricohyoidopexy (CHP) oncologic results were very close (Fig. 1). No substantial statistical difference was recorded in survival percentage after enlarged supraglottic larynx resection (70.51% and 61.66%) and supracricoid one with CHP (68.54% and 58.43%), nor in percentage of local recurrences (4.4% and 5.7%). The efficiency of the residual larynx was dependent on the extent of the resection. From the discussed types of operations the best functional results were achieved after classic supraglottic and glottic larynx resections. This was distinct in the best quality of speech, efficient respiratory tract protection and high percentage of decannulated cases (93%). In the glottic resection the respiratory tract protection was satisfactory in 9/11 patients and in 7/8 satisfactory speech quality was noticed. Following the extended laryngeal structures resection (extended supraglotic and supracricoid laryngectomies) worse protection of respiratory tract, higher percentage of not decannulated cases and worse quality of speech were observed than in operation previously discussed. It was proved that the one-stage reconstruction of the laryngeal structures (arytenoid cartilage and/or vocal cord) or base of the tongue improves the result considerably, in particular the deglutition and phonation. The oncologic and functional results after the discussed types of operation should stimulate their more frequent application in larynx cancer treatment.

Adolescent↗

PubMed2001

Unilateral vs. bilateral supraglottoplasty for severe laryngomalacia in children.

OBJECTIVES: To study the efficacy of unilateral supraglottoplasty in comparison with bilateral supraglottoplasty for the treatment of severe laryngomalacia in children and to study factors that may be predictive of major complications or the need for a subsequent contralateral or revision procedure. DESIGN: Retrospective medical record review. SETTING: University tertiary care pediatric hospital. PATIENTS: One hundred six consecutive pediatric patients, aged 9 days to 18 years, who had undergone unilateral or bilateral supraglottoplasty for severe laryngomalacia. MAIN OUTCOME MEASURES: Resolution of clinically significant laryngomalacia, development of major complications (supraglottic stenosis or aspiration), and an association between study variables (demographics, medical comorbidities, synchronous airway abnormalities, sites of excision, and techniques of excision) and the need for subsequent contralateral or revision supraglottoplasty. RESULTS: We achieved a high success rate (95.7%), a low complication rate (8.5%), and observed the need for a contralateral procedure in 7 (14.9%) of the 47 patients who underwent initial unilateral supraglottoplasty. Two patients who underwent initial bilateral supraglottoplasty developed supraglottic stenosis. No significant association existed between our study variables and the development of complications or the need for contralateral or revision supraglottoplasty. CONCLUSIONS: Unilateral supraglottoplasty was associated with a high success rate, low complication rate, and the avoidance of supraglottic stenosis in our study population. The percentage of patients requiring a subsequent contralateral procedure was comparable to that reported in the literature, and no major complications were associated with the second operation in these patients. Therefore, unilateral supraglottoplasty seems to be a reasonable option for initial surgical management of pediatric patients with severe laryngomalacia.

Adolescent↗

PubMed2003

Failures and complications of supraglottoplasty in children.

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.

Airway Obstruction↗