Supraglottoplasty

Overview  

Supraglottoplasty is a surgical procedure that removes excess tissue from the larynx (voice box) to prevent it from obstructing the airway and interfering with breathing. While it is most commonly performed on infants, it can also be necessary for older children and adults when nonsurgical treatments prove ineffective. The surgery is generally safe, quick, and effective, with most patients, including infants, resuming normal routines within a couple of weeks. 

Reasons for undergoing the procedure  

Supraglottoplasty is a surgical procedure commonly performed to treat laryngomalacia, a condition where babies have floppy tissue around their voice boxes that obstructs their airways. About 20% of infants with laryngomalacia require this surgery, which reshapes or removes the tissue to improve breathing, eating, and sleeping—essential for their overall development. In severe cases, it helps prevent weight loss caused by excessive calorie burning due to breathing difficulties. Supraglottoplasty is also sometimes used to address Obstructive Sleep Apnea (OSA) in both children and adults, with its primary benefit being the enhancement of breathing. 

Risks   

Supraglottoplasty is generally a safe procedure with reliable outcomes, but it does carry some risks. Potential complications after the surgery may include:  

• Aspiration (inhalation of food or liquids into the airways)  
• Blood clots  
• Persistent respiratory issues  
• Injury to nearby structures  
• Difficulty with swallowing  
• Severe bleeding  
• Infection

Your child’s doctor will closely monitor their recovery to ensure it progresses as expected. A one-night hospital stay will allow the doctor to be readily available to address any potential issues.  

Before the procedure  

Preparing for supraglottoplasty generally requires minimal steps. However, if you have acid reflux, your surgeon might recommend taking medication a few days before the surgery to help prevent reflux-related problems. 

Your surgeon may also order a swallow study, an imaging test to ensure proper swallowing of food.

In addition, you will likely need to refrain from eating and drinking for several hours before the surgery. Your healthcare provider will give you specific preoperative instructions based on your individual situation.  

During the procedure  

Under general anesthesia, medical professionals perform supraglottoplasty at a hospital. They could accomplish it using laser therapy or more conventional surgical tools. The appropriate course of action for your circumstances might be advised by your provider. 

During a supraglottoplasty, the following procedures can be anticipated:  

• The anesthesiologist administers anesthesia; surgeon: views your voice box with a laryngoscope. The aryepiglottic folds, which are triangular folds of mucous membrane on either side of your larynx, will be sliced (incised).  
• To remove and restructure superfluous tissue, microscopic devices will be used.   
• The surgeon will use gauze to prevent bleeding. 

The average surgical time for supraglottoplasty is less than one hour. Your kid will likely need to stay in the hospital overnight for observation, even though the procedure is brief.  

Outcome  

Recovery from supraglottoplasty usually takes one to two weeks, though this can vary depending on the extent of the surgery and the severity of your baby’s condition.

It’s common for your baby to experience some swelling and discomfort initially. Feeding may be difficult, and their breathing might sound worse immediately after the procedure. These symptoms are typically temporary and not a cause for concern. However, if your child’s symptoms worsen or don’t improve after two weeks, you should contact your doctor.

Success rates for supraglottoplasty are estimated to range from 70% to 100%. Children with certain syndromes, neurological disorders, or heart abnormalities may have lower success rates. Overall, the procedure often leads to a significant improvement in your child’s quality of life.