(390) Post-operative Safety of Pediatric Supraglottoplasty

Introduction: Laryngomalacia is the most common anomaly of the larynx and cause of stridor in the newborn. Supraglottoplasty has become the standard of care for operative management of severe laryngomalacia. The purpose of this study was to determine the incidence of adverse events in the first 14 days in post supraglottoplasty pediatric patients. Our second aim was to determine if postoperative hospital admission after supraglottoplasty in pediatric patients is necessary.

Methods: This study was a retrospective review of pediatric patients who underwent supraglottoplasty at a tertiary care center. Data were obtained from January 2017 until December 2020, totaling 107 patients. Pediatric patients who underwent supraglottoplasty were included in the study. Patients who underwent additional airway procedures at time of supraglottoplasty, such as palatine tonsillectomy and lingual tonsillectomy, were excluded. Information regarding patient's demographics, length of post-operative hospital stay, co-morbid conditions, unit of hospital admission, intra-operative and post-operative adverse events, and readmission within the first 14 days was gathered and analyzed. Data were compared between patients who had postoperative complications and hospital readmissions within two weeks of surgery to those who did not. Continuous data were assessed using Wilcoxon rank sum tests and categorical variables were assessed using chi-squared tests.

Results: The incidence of post-operative adverse events for all subjects after supraglottoplasty was 5.7% (N=6). The most common complications were respiratory distress (N=2), followed by substernal retractions, stridor, and decreased oral intake (N=1). There was no statistically significant increased incidence in any group of patients, regardless of their unit of stay post-operatively (p=0.39).

Conclusions: Supraglottoplasty is a safe surgical option for patients with severe laryngomalacia. While each patient's care is individualized, we demonstrate that post-operative hospital admission is not necessary in healthy children undergoing supraglottoplasty.