CO2 laser supraglottoplasty for infantile laryngomalacia

Objective To evaluate the feasibility and safety of CO2 laser supraglottoplasty for severe laryngomalaeia in infants. Methods From January 2009 to December 2011, 32 infants with severe laryngomalacia were confirmed by electronic laryngoscope and clinical assessment in Shenzhen Children's Hospital. According to the choice made by the parents, 16 children accepted CO2 laser supraglottoplasty （group 1）, the others were treated conservatively （group 2）. The beginning observation point TO was defined as the age on the first medicine taking day or the age of surgery. T1, T3, T6 were defined as 1, 3, 6 months following TO. Clinical symptoms included stridor, dyspnea, aspiration, and respiratory infections. The body weight, PSG reports, laryngoscope findings, cure rates of the two groups were compared. Results The anatomical abnormalities were corrected surgically, and the symptoms , such as stridor, dyspnea, and aspiration improved rapidly after the operation. The cure rates was higher in group 1 than in group 2 on T1, T3, T6 stage. There were statistically significant differences （χ2 were 13.9, 28.1, 24.6 respectively ; all P < 0.01）. Children in group 1 gained weight better than in group 2. There was a statistically significant difference in Z scores median on T1, T3, T6 stage （z score were -0.848, -2.940, -4.110; P <0.05 ,or P < 0.01 respectively）. The lowest oxygen saturation in group 1 improved one month after the surgery （from average 0.686 ± 0.106 to 0.901 ± 0.041）. There was a statistically significant difference （t = - 7.876, P =0.001）. Complications included adhesion （1 case） and temporary new-onset aspiration （1 case）. Conclusions The CO2 laser supraglottoplasty can resolve severe laryngomalacia symptoms including stridor, dyspnea and aspiration. It can reduce the frequency of respiratory infections, and contribute to weight gaining. The CO2 laser supraglottoplasty is effective, of high security and with rare complications. Key words: Infant; Laryngomalacia; Laser therapy