Swallowing Outcomes Following Supraglottoplasty: A Retrospective Review

• Published in: The Laryngoscope 2021-12, Vol.131 (12), p.2817-2822
• Main Authors: Nguyen, Mai, Brooks, Laura, Wetzel, Martha, Raol, Nikhila
• Format: Article
• Language: English
• Subjects: Dysphagia; Laryngoscopy; Pediatrics; Supraglottoplasty; swallow outcomes; Swallowing
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.29704

Objectives/Hypothesis Determine the incidence of short‐ and long‐term dysphagia in pediatric patients with and without syndromes/neurodevelopmental delay following supraglottoplasty (SGP) at our institution. Study Design Retrospective cohort study. Methods A retrospective cohort study of children ≤18 years old who underwent SGP from 2014 to 2019 was undertaken. Age at surgery, sex, race, insurance, underlying syndromes/neurodevelopmental delay, concurrent surgical procedures, and clinical swallowing assessments were reviewed. Logistic regression was performed to identify factors associated with postoperative feeding difficulties. Time‐to‐event analysis was performed to assess time to resolution of dysphagia. Results A total of 231 patients were identified. Average age at time of SGP was 13.7 months. Of 231 patients, 88 (38.1%) had a syndrome/neurodevelopmental delay. Of these 231 patients, 112 had a preoperative videofluoroscopic swallow study or fiberoptic endoscopic evaluation of swallowing, of whom 53/112 (47.3%) had dysphagia. After SGP, 138/231 (59.7%) underwent clinical/instrumental swallowing assessments, of whom 95/138 (68.8%) had immediate postsurgical dysphagia. At last follow‐up (1 month to 45 months), 15/95 (15.8%) had persistent dysphagia on instrumental assessment, 14/15 of whom had syndromes/neurodevelopmental delay. Time‐to‐event analysis revealed that for the nonsyndromic cohort, 25% had resolution of dysphagia by 4 months, 50% by 10 months, and 75% by 14 months. Cox proportional hazards regression revealed that the presence of underlying syndromes/neurodevelopmental delay was the only factor predictive of long‐term postoperative dysphagia (hazard ratio of resolution 0.21 [95% confidence interval 0.096–0.48]). Conclusions While short‐term feeding difficulties following SGP in pediatric patients are not uncommon, long‐term dysphagia is rare in patients without syndromes/neurodevelopmental delay. These data can be used when counseling caregivers about the risks and benefits of SGP. Level of Evidence 4 Laryngoscope, 131:2817–2822, 2021