کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
4114201 | 1606060 | 2010 | 5 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Supraglottoplasty outcomes in relation to age and comorbid conditions Supraglottoplasty outcomes in relation to age and comorbid conditions](/preview/png/4114201.png)
ObjectiveTo determine if age and comorbid conditions effect outcomes in children undergoing supraglottoplasty for severe laryngomalacia.DesignRetrospective study.SettingUrban tertiary-care children's hospital.PatientsChildren undergoing supraglottoplasty for severe laryngomalacia between February 2004 and July 2008. 56 patients were identified.Outcome measuresPersistence of upper airway obstruction, revision surgery (supraglottoplasty), and additional surgery (tracheostomy).Results33/56 (58.9%) patients had no comorbid conditions and 23/56 (41.1%) patients had comorbid conditions. In noncomorbid patients, 36.4% of those less than 2 months of age at the time of surgery required revision supraglottoplasty, compared to 5.3% of patients between 2 and 10 months (p < 0.05). Compared to the 2–10-month age group, there was a significantly higher percentage of patients with comorbid conditions in the >10-month group (32.1% vs. 79%, p < 0.01). Patients with comorbid conditions were diagnosed at a significantly later age than those without (6 mo vs. 2 mo, respectively), and had significantly higher rates of revision supraglottoplasty (47.8% vs. 18.2%) and tracheostomy (39.1% vs. 0.0%). 70% of children with neurological conditions required revision surgery, with 60% requiring tracheostomy. The revision surgery and tracheostomy rates were significantly higher compared to the noncomorbid group (p < 0.01 and p < 0.0001). Children with cardiac conditions had a higher rate of tracheostomy than noncomorbid children (30% vs. 0%, p < 0.01). 16.7% of children with genetic conditions required supraglottoplasty, and none required tracheostomy.ConclusionsIn noncomorbid patients, those undergoing supraglottoplasty less than 2 months of age had a significantly higher rate of revision supraglottoplasty. Patients with neurologic and cardiac comorbidities require tracheostomy at a significantly higher rate than noncomorbid patients.
Journal: International Journal of Pediatric Otorhinolaryngology - Volume 74, Issue 3, March 2010, Pages 245–249