Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique

Objectives. In this study, we review our institutional experience with pediatric laryngomalacia (LM) and report our experiences of patients undergoing supraglottoplasty using the spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen (STRIVE Hi) technique. Methods. The medic...

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Autores principales:	Hyunkyung Cha, Doh Young Lee, Eun-Hee Kim, Ji-Hyun Lee, Young-Eun Jang, Hee-Soo Kim, Seong Keun Kwon
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society of Otorhinolaryngology-Head and Neck Surgery 2021
Materias:	laryngomalacia airway management strive hi anesthesia surgical procedure supraglottoplasty Medicine R Otorhinolaryngology RF1-547
Acceso en línea:	https://doaj.org/article/0db15712243b4f7dafdad5b1781fe222
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spelling	oai:doaj.org-article:0db15712243b4f7dafdad5b1781fe2222021-11-18T02:29:22ZFeasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique1976-87102005-072010.21053/ceo.2020.02061https://doaj.org/article/0db15712243b4f7dafdad5b1781fe2222021-11-01T00:00:00Zhttp://www.e-ceo.org/upload/pdf/ceo-2020-02061.pdfhttps://doaj.org/toc/1976-8710https://doaj.org/toc/2005-0720Objectives. In this study, we review our institutional experience with pediatric laryngomalacia (LM) and report our experiences of patients undergoing supraglottoplasty using the spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen (STRIVE Hi) technique. Methods. The medical records of 29 children with LM who visited Seoul National University Hospital between January 2017 and March 2019 were retrospectively reviewed. Surgical management was performed using the STRIVE Hi technique. Intraoperative findings and postoperative surgical outcomes, including complications and changes in symptoms and weight, were analyzed. Results. Of the total study population of 29 subjects, 20 (68.9%) were female. The patients were divided according to the Onley classification as follows: type I (n=13, 44.8%), II (n=10, 34.5%), and III (n=6, 20.7%). Twenty-five patients (86.2%) had comorbidities. Seventeen patients (58.6%) underwent microlaryngobronchoscopy under STRIVE Hi anesthesia. Four patients with several desaturation events required rescue oxygenation by intermittent intubation and mask bagging during the STRIVE Hi technique. However, the procedure was completed in all patients without any severe adverse effects. Overall, 15 children (51.7%) underwent supraglottoplasty, of whom 14 (93.3%) showed symptom improvement, and their postoperative weight percentile significantly increased (P=0.026). One patient required tracheostomy immediately after supraglottoplasty due to associated neurological disease. Conclusion. The STRIVE Hi technique is feasible for supraglottoplasty in LM patients, while type III LM patients with micrognathia or glossoptosis may have a higher risk of requiring rescue oxygenation during the STRIVE Hi technique.Hyunkyung ChaDoh Young LeeEun-Hee KimJi-Hyun LeeYoung-Eun JangHee-Soo KimSeong Keun KwonKorean Society of Otorhinolaryngology-Head and Neck Surgeryarticlelaryngomalaciaairway managementstrive hianesthesiasurgical proceduresupraglottoplastyMedicineROtorhinolaryngologyRF1-547ENClinical and Experimental Otorhinolaryngology, Vol 14, Iss 4, Pp 414-423 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	laryngomalacia airway management strive hi anesthesia surgical procedure supraglottoplasty Medicine R Otorhinolaryngology RF1-547
spellingShingle	laryngomalacia airway management strive hi anesthesia surgical procedure supraglottoplasty Medicine R Otorhinolaryngology RF1-547 Hyunkyung Cha Doh Young Lee Eun-Hee Kim Ji-Hyun Lee Young-Eun Jang Hee-Soo Kim Seong Keun Kwon Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique
description	Objectives. In this study, we review our institutional experience with pediatric laryngomalacia (LM) and report our experiences of patients undergoing supraglottoplasty using the spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen (STRIVE Hi) technique. Methods. The medical records of 29 children with LM who visited Seoul National University Hospital between January 2017 and March 2019 were retrospectively reviewed. Surgical management was performed using the STRIVE Hi technique. Intraoperative findings and postoperative surgical outcomes, including complications and changes in symptoms and weight, were analyzed. Results. Of the total study population of 29 subjects, 20 (68.9%) were female. The patients were divided according to the Onley classification as follows: type I (n=13, 44.8%), II (n=10, 34.5%), and III (n=6, 20.7%). Twenty-five patients (86.2%) had comorbidities. Seventeen patients (58.6%) underwent microlaryngobronchoscopy under STRIVE Hi anesthesia. Four patients with several desaturation events required rescue oxygenation by intermittent intubation and mask bagging during the STRIVE Hi technique. However, the procedure was completed in all patients without any severe adverse effects. Overall, 15 children (51.7%) underwent supraglottoplasty, of whom 14 (93.3%) showed symptom improvement, and their postoperative weight percentile significantly increased (P=0.026). One patient required tracheostomy immediately after supraglottoplasty due to associated neurological disease. Conclusion. The STRIVE Hi technique is feasible for supraglottoplasty in LM patients, while type III LM patients with micrognathia or glossoptosis may have a higher risk of requiring rescue oxygenation during the STRIVE Hi technique.
format	article
author	Hyunkyung Cha Doh Young Lee Eun-Hee Kim Ji-Hyun Lee Young-Eun Jang Hee-Soo Kim Seong Keun Kwon
author_facet	Hyunkyung Cha Doh Young Lee Eun-Hee Kim Ji-Hyun Lee Young-Eun Jang Hee-Soo Kim Seong Keun Kwon
author_sort	Hyunkyung Cha
title	Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique
title_short	Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique
title_full	Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique
title_fullStr	Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique
title_full_unstemmed	Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique
title_sort	feasibility of surgical treatment for laryngomalacia using the spontaneous respiration technique
publisher	Korean Society of Otorhinolaryngology-Head and Neck Surgery
publishDate	2021
url	https://doaj.org/article/0db15712243b4f7dafdad5b1781fe222
work_keys_str_mv	AT hyunkyungcha feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique AT dohyounglee feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique AT eunheekim feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique AT jihyunlee feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique AT youngeunjang feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique AT heesookim feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique AT seongkeunkwon feasibilityofsurgicaltreatmentforlaryngomalaciausingthespontaneousrespirationtechnique
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Feasibility of Surgical Treatment for Laryngomalacia Using the Spontaneous Respiration Technique

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