Counseling Families on Long-Term Outcomes After Supraglottoplasty for Laryngomalacia: A Single-Surgeon Patient-Reported Outcome Cohort With 15-Year Follow-Up.

Abstract

Objective: To provide long-term patient-reported outcome data to inform preoperative counseling for supraglottoplasty, and to determine whether any residual symptom burden reflects ongoing laryngeal dysfunction or broader health factors such as comorbidity.

Methods: Retrospective cohort study with cross-sectional long-term follow-up at a tertiary pediatric hospital in Perth, WA. Patients who underwent supraglottoplasty for severe laryngomalacia between 2006 and 2011 by a single surgeon were administered the Laryngomalacia Quality-of-Life Questionnaire (LQQ) via electronic survey. Descriptive statistics, internal consistency (Cronbach α) and Mann-Whitney U testing were performed.

Results: Twenty-eight of 63 families completed the survey (44.4%). Median age at surgery was 3.8 months; median follow-up from surgery was 15 years. The median total LQQ score was 43 (IQR 36.5-58), corresponding to a median item score of 1.48/5 (mean 1.65/5). Airway and Feeding/Swallowing domains demonstrated low patient-reported symptom burden. Six patients (21.4%) reported higher total scores (> 60 points), predominantly within the general quality-of-life domain. Patients with comorbidities had significantly higher general quality-of-life domain scores (p = 0.022, r = 0.55); airway and feeding/swallowing domains did not differ by comorbidity status.

Conclusion: At a median of 15 years following supraglottoplasty, patients reported minimal laryngeal symptom burden. Symptoms were largely confined to the general quality-of-life domain and may reflect comorbid conditions rather than laryngeal pathology. These long-term data may support preoperative counseling.

Level of evidence: 4.