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Pediatric Otolaryngology

(468) Swallowing Function After Epiglottopexy in Children

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Senior Author(s)

  • IH

    Inbal Hazkani, MD

    Faculty
    Lurie Childrens Hospital/ Northwestern University
    Chicago, Illinois, United States

    • Presenting Author(s)

  • Ashley E. Young, BS

    Medical Student
    Northwestern University
    Lincolnshire, Illinois, United States

    • Co-Author(s)

  • LH

    Laura Hinkes-Molinaro, MA CCC-SLP

    Director, Speech-Language Pathology and Audiology
    Lurie Children's Hospital
    Chicago, Illinois, United States

  • Jonathan B. Ida, MD

    Associate Professor, Otolaryngology - Head & Neck Surgery
    Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine
    Chicago, Illinois, United States

  • Taher S. Valika, MD

    Assistant Professor
    Lurie Children's Hospital, Northwestern University
    Chicago, IL, United States

  • Saied Ghadersohi, MD

    Assistant Professor
    Lurie Children's Hospital, Northwestern University
    Chicago, IL, United States

  • Dana M. Thompson, MD

    Professor; Division Head, Otorhinolaryngology - Head and Neck Surgery
    Lurie's Children's Hospital of Chicago/Northwestern University Feinberg School of Medicine
    Chicago, Illinois, United States

Disclosure(s):
Inbal Hazkani, MD: No relevant relationships to disclose.
Ashley E. Young, BS: No relevant relationships to disclose.
Laura Hinkes-Molinaro, MA CCC-SLP: No relevant relationships to disclose.
Jonathan B. Ida, MD: No relevant relationships to disclose.
Taher S. Valika, MD: No relevant relationships to disclose.
Dana M. Thompson, MD: No relevant relationships to disclose.


Introduction: Epiglottopexy has been an increasingly utilized intervention in children with epiglottic prolapse and airway obstruction. Given the role of the epiglottis in protecting the airway during swallowing and the potential effect of repositioning the epiglottis on the passage of the bolus, we aimed to compare swallowing outcomes before and after epiglottopexy in children.

Methods: A retrospective chart review of children who underwent epiglottopexy and had a subsequent instrumental swallowing evaluation between 1/2018 to 9/2022.

Results: A total of 93 patients underwent epiglottopexy. Of these, 38 patients met inclusion requirements. The mean age at surgery was 41 ± 47 months. Most patients (n=37, 97.4%) had significant comorbidities such as secondary airway lesions (n=33, 91.7%), a genetic or syndromic disorder (n=25, 69.4%), and dysphagia (n=29, 76.3%). All patients had a concurrent procedure at time of epiglottopexy with supraglottoplasty (n=24, 63.2%) and lingual tonsillectomy (n=16, 42.1%) being the most common. No changes in initiation or patterns of swallowing were noted postoperatively. A total of 7 (18.4%) patients had worsening swallow function: 3 had new-onset dysphagia, and 4 had worsening pre-existing dysphagia. The highest consistency level penetrated or aspirated remained unchanged or improved in most cases (n=25, 78.1%). No risk factors for worsening dysphagia were identified in our cohort.

Conclusions: Children with medical comorbidities undergoing epiglottopexy with additional airway interventions may experience new or worsening dysphagia. However, the procedure is generally safe without notable patterned changes in the swallowing mechanism.