Supraglottoplasty outcomes and peri-operative care in congenital laryngomalacia.

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This study aimed to identify factors predicting postoperative ICU admission, the need for orotracheal intubation (OTI), and the occurrence of supraglottic stenosis in children undergoing supraglottoplasty for laryngomalacia. A retrospective analysis was conducted on 31 children (Dear Reviewer, we would have greatly preferred to include a larger sample size. However, as you know, this type of management is rare, and we deliberately selected a 7-year period to ensure a minimum of 30 children while avoiding significant differences in management guidelines over time. Thank you for your understanding.) who underwent supraglottoplasty at Robert Debre University Hospital from February 2016 to June 2023. Patient demographics, medical history, pre- and postoperative findings, and outcomes were evaluated. Statistical analyses were performed using R software. A total of 60% of patients required ICU admission postoperatively. Factors predictive of ICU admission included a history of genetic anomalies, younger age at surgery, poor weight gain, and preoperative enteral feeding. Among those requiring OTI, significant predictors included a history of neurological disease, abnormal vocal cord mobility, and intraoperative arterial oxygen saturation dropping below 90%. Two patients developed supraglottic stenosis, with a noted correlation to surgical technique and preoperative respiratory severity. While supraglottoplasty is generally safe and effective, specific factors can predict the need for postoperative ICU care and intubation. The findings highlight the importance of thorough preoperative assessments and optimization of gastroesophageal reflux management to mitigate complications.