UNILATERAL ENDOSCOPIC SUPRAGLOTTOPLASTY FOR SEVERE LARYNGOMALACIA

Objective: To evaluate the effectiveness of unilateral supraglottoplas ty in the treatment of children with severe laryngomalacia. Design: Re trospective study. Setting: Pediatric tertiary referral center. Patien ts: Eighteen children with severe laryngomalacia. Indications for surg ical intervention were obstructive apnea, failure to thrive, cyanosis, and/or cor pulmonale. Interventions: Unilateral carbon dioxide laser removal of redundant supraglottic tissue (supraglottoplasty). Outcome Measures: Evaluation of relief of symptoms, need for subsequent contra lateral procedure, and incidence of complications. Results: Three pati ents required treatment of the opposite side at a later date. There we re no complications. Obstructive apnea and weight gain improved in all . Conclusions: Unilateral supraglottoplasty can be used to treat sever e laryngomalacia in most patients. A small percentage of patients will subsequently require a contralateral procedure. Unilateral supraglott oplasty may have less risk of complications than bilateral supraglotto plasty.