Supraglottoplasty outcomes in relation to age and comorbid conditions.
Int J Pediatr Otorhinolaryngol
; 74(3): 245-9, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20022388
ABSTRACT
OBJECTIVE:
To determine if age and comorbid conditions effect outcomes in children undergoing supraglottoplasty for severe laryngomalacia.DESIGN:
Retrospective study.SETTING:
Urban tertiary-care children's hospital. PATIENTS Children undergoing supraglottoplasty for severe laryngomalacia between February 2004 and July 2008. 56 patients were identified. OUTCOMEMEASURES:
Persistence of upper airway obstruction, revision surgery (supraglottoplasty), and additional surgery (tracheostomy).RESULTS:
33/56 (58.9%) patients had no comorbid conditions and 23/56 (41.1%) patients had comorbid conditions. In noncomorbid patients, 36.4% of those less than 2 months of age at the time of surgery required revision supraglottoplasty, compared to 5.3% of patients between 2 and 10 months (p<0.05). Compared to the 2-10-month age group, there was a significantly higher percentage of patients with comorbid conditions in the >10-month group (32.1% vs. 79%, p<0.01). Patients with comorbid conditions were diagnosed at a significantly later age than those without (6 mo vs. 2 mo, respectively), and had significantly higher rates of revision supraglottoplasty (47.8% vs. 18.2%) and tracheostomy (39.1% vs. 0.0%). 70% of children with neurological conditions required revision surgery, with 60% requiring tracheostomy. The revision surgery and tracheostomy rates were significantly higher compared to the noncomorbid group (p<0.01 and p<0.0001). Children with cardiac conditions had a higher rate of tracheostomy than noncomorbid children (30% vs. 0%, p<0.01). 16.7% of children with genetic conditions required supraglottoplasty, and none required tracheostomy.CONCLUSIONS:
In noncomorbid patients, those undergoing supraglottoplasty less than 2 months of age had a significantly higher rate of revision supraglottoplasty. Patients with neurologic and cardiac comorbidities require tracheostomy at a significantly higher rate than noncomorbid patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Otorrinolaringológicos
/
Glote
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Prognostic_studies
Limite:
Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article