Evaluating the Impact of Comorbidities & Synchronous Airway Lesions in Children with Laryngomalacia.

Abstract

Supraglottoplasty is performed in children diagnosed with laryngomalacia experiencing persistent respiratory difficulties and failure to thrive. The objective of this study is to assess the impact of comorbidities and synchronous airway lesions to post-operative recovery and overall patient well-being during follow up. This is a retrospective review on the outcomes of supraglottoplasty performed at a tertiary pediatric hospital from May 2023 to August 2024. A total of 11 patients included, majority having comorbidities and synchronous airway lesions. Results showed that despite higher surgical risks, all patients achieved substantial improvements with 50% or greater in respiratory function at follow-up. Although some experienced delayed extubation and required prolonged feeding support, all were gradually weaned off oxygen post-operatively. The choice of surgical instrument did not affect outcomes. Supraglottoplasty outcomes are complex in patients with comorbidities due to increased surgical risks and extended post-operative care, including delayed extubation, prolonged respiratory and feeding assistance. Despite these challenges, all patients achieved at least 50% improvement in respiratory symptoms within 3 months post-surgery. Although presence of synchronous airway lesions prolonged recovery time but significant improvements was seen in breathing. While children without comorbidities typically had the best outcomes, those with comorbidities also benefited from surgery when managed by multidisciplinary team. The choice of surgical instruments did not significantly impact outcomes, highlighting that post-operative care and patient factors are key to recovery. Supraglottoplasty increases risks in patients with comorbidities and synchronous airway lesions but benefits of surgery outweigh these risks. This study emphasizes importance of multidisciplinary approach and post-operative care for achieving successful outcomes in this population.