Unilateral endoscopic supraglottoplasty for severe laryngomalacia.

Objective: To evaluate the effectiveness of unilateral supraglottoplasty in the treatment of children with severe laryngomalacia.

Methods: Retrospective study. Methods: Pediatric tertiary referral center. Methods: Eighteen children with severe laryngomalacia. Indications for surgical intervention were obstructive apnea, failure to thrive, cyanosis, and/or cor pulmonale. Methods: Unilateral carbon dioxide laser removal of redundant supraglottic tissue (supraglottoplasty). Methods: Evaluation of relief of symptoms, need for subsequent contralateral procedure, and incidence of complications.

Results: Three patients required treatment of the opposite side at a later date. There were no complications. Obstructive apnea and weight gain improved in all.

Conclusions: Unilateral supraglottoplasty can be used to treat severe laryngomalacia in most patients. A small percentage of patients will subsequently require a contralateral procedure. Unilateral supraglottoplasty may have less risk of complications than bilateral supraglottoplasty.