A Systematic Review of Supraglottoplasty Outcomes

Objectives: To analyze the available published data on supraglottoplasty, epiglottoplasty, and laryngomalacia and to evaluate the relative risk of supraglottoplasty failure. Design: Systematic review with determination of relative risk. Main Outcome Measures: A PubMed search was performed with the following inclusion criteria: English language, human subjects, supraglottoplasty, epiglottoplasty, and laryngomalacia. The results of the included studies were summarized and analyzed. Subgroup analysis was then performed. Results: Twelve studies were identified, with 8 meeting the inclusion criteria. The overall risk ratio of surgical failure among patients with associated comorbidities compared with those with isolated laryngomalacia was 7.14 (k=6 studies; 95% CI, 3.73-13.74; P<.001). The risk ratio for persistent or significant aspiration after supraglottoplasty among patients with associated comorbidities compared with those with isolated laryngomalacia was 4.33 (k=3 studies; 95% CI, 1.25-15.06; P=.02). Insufficient data were available to assess outcome by age at surgery or specific technique used. Conclusions: The relative risk of supraglottoplasty failure is significantly higher among patients with associated medical comorbidities. This aggregate finding should be taken into account when parents are counseled as to the expected surgical outcome of infants with laryngomalacia who are undergoing supraglottoplasty.