Changes in sleep apnea after supraglottoplasty in infants with laryngomalacia

Abstract Objective To determine the clinical and polysomnography outcomes in infants with laryngomalacia undergoing supraglottoplasty. Methods Infants ( Results 20 children met inclusion criteria. Statistically significant improvements were found in pre- to postoperative median values for apnea-hypopnea index (AHI) (median change: −6.4 points, p  = 0.02) and obstructive apnea index (median change: −2.9 points, p  = 0.01) values. Obstructive AHI, O 2 saturation nadir, and percentage of sleep spent with 2 saturation improved, although not significantly. Postoperative AHI scores correlated with improvements in stridor in 80% of patients. Stratification showed similar improvements in AHI after supraglottoplasty regardless of reflux treatment, secondary airway lesions, age at supraglottoplasty, or time lag between supraglottoplasty and postoperative polysomnography. Secondary airway lesions are the only potential confounders shown to have significantly better improvements in O 2 nadir. While the sleep study improved in patients with AHI >5, infants with AHI Conclusion Supraglottoplasty may be an effective and safe option to improve moderate to severe obstructive sleep apnea in infants with laryngomalacia. In addition, polysomnography may be useful in infants with laryngomalacia to identify obstructive sleep apnea and/or to objectively measure outcomes after supraglottoplasty. This pilot study warrants a larger, prospective, and controlled study to validate these findings.