{
    "abstract": "There is growing research on the association between swallowing dysfunction and laryngomalacia. Supraglottoplasty is the surgical intervention used to treat laryngomalacia, however a portion of patients who undergo this procedure will require a revision surgery. Predictive risk factors for revision supraglottoplasty in patients with laryngomalacia are not well understood, and previous studies failed to evaluate swallowing systematically.\nWe predict a significant association between swallowing dysfunction and revision supraglottoplasty for patients with laryngomalacia.\nThis was a retrospective cohort study of consecutive patients between 2013 and 2023\u00a0at a tertiary pediatric care centre (Stollery Children's Hospital). All patients had an endoscopic diagnosis of laryngomalacia by a staff otolaryngologist and at minimum a systematic clinical swallowing assessment by a speech language pathologist, with an instrumental assessment as needed. Patients with genetic or neurological comorbidities, lack of follow up information, or age of >3 years were excluded. Clinical and instrumental swallow data, demographic information, surgical outcomes and revision surgeries were documented and collected. Univariate analysis was done to determine associations between variables and revision supraglottoplasty. Binary logistic regression was done to determine independent predictors of revision supraglottoplasty.\n214 patients met the inclusion criteria and were analyzed in the study. 24 patients (11\u00a0%) required revision supraglottoplasty. 118 out of the 214 patients (55\u00a0%) had an instrumental assessment completed (FEES or VFSS). Of those, 92 (78\u00a0%) had abnormal findings on instrumental assessments. Univariate analysis showed Type 2 laryngomalacia (P\u00a0=\u00a00.017), presence of aspiration (P=<0.001), presence of cyanosis (P\u00a0=\u00a00.002) and abnormal findings on an instrumental assessment (P\u00a0=\u00a00.013) to be significantly associated with the need for revision supraglottoplasty. Binary regression analysis showed aspiration (OR\u00a0=\u00a05.6 {2.087-14.889}, P=<0.001) and cyanosis (OR\u00a0=\u00a05.3 {1.852-15.181}, P\u00a0=\u00a00.002) to be the only independent predictors of revision supraglottoplasty.\nPresence of aspiration is a strong predictive factor for revision supraglottoplasty in patients with laryngomalacia, when swallowing is evaluated systematically. More prospective research is needed to understand the relationship between swallowing dysfunction, laryngomalacia and surgery.",
    "authors": [
        {
            "affiliation": "Division of Pediatric Surgery, Stollery Children's Hospital, Department of Surgery, University of Alberta, Edmonton, AB, Canada.",
            "firstname": "Amy",
            "initials": "A",
            "lastname": "Callaghan"
        },
        {
            "affiliation": "Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada; Division of Pediatric Surgery, Stollery Children's Hospital, Department of Surgery, University of Alberta, Edmonton, AB, Canada.",
            "firstname": "Hamdy",
            "initials": "H",
            "lastname": "El-Hakim"
        },
        {
            "affiliation": "Department of Rehabilitation Medicine, Stollery Children's Hospital, Edmonton, AB, Canada.",
            "firstname": "Amanda R",
            "initials": "AR",
            "lastname": "Adsett"
        },
        {
            "affiliation": "Division of Pediatric Gastroenterology, Department of Pediatrics, Stollery Children's Hospital, Canada.",
            "firstname": "Daniela M",
            "initials": "DM",
            "lastname": "Isaac"
        },
        {
            "affiliation": "Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada; Division of Pediatric Surgery, Stollery Children's Hospital, Department of Surgery, University of Alberta, Edmonton, AB, Canada. Electronic address: aisaac@ualberta.ca.",
            "firstname": "Andre",
            "initials": "A",
            "lastname": "Isaac"
        }
    ],
    "conclusions": "Presence of aspiration is a strong predictive factor for revision supraglottoplasty in patients with laryngomalacia, when swallowing is evaluated systematically. More prospective research is needed to understand the relationship between swallowing dysfunction, laryngomalacia and surgery.",
    "copyrights": "Copyright \u00a9 2024 The Authors. Published by Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.ijporl.2024.112115",
    "journal": "International journal of pediatric otorhinolaryngology",
    "keywords": [
        "Aspiration",
        "Dysphagia",
        "Laryngomalacia",
        "Pediatrics",
        "Revision supraglottoplasty",
        "Supraglottoplasty",
        "Swallowing dysfunction"
    ],
    "methods": null,
    "publication_date": "2024-09-21",
    "pubmed_id": "39303556",
    "results": "214 patients met the inclusion criteria and were analyzed in the study. 24 patients (11\u00a0%) required revision supraglottoplasty. 118 out of the 214 patients (55\u00a0%) had an instrumental assessment completed (FEES or VFSS). Of those, 92 (78\u00a0%) had abnormal findings on instrumental assessments. Univariate analysis showed Type 2 laryngomalacia (P\u00a0=\u00a00.017), presence of aspiration (P=<0.001), presence of cyanosis (P\u00a0=\u00a00.002) and abnormal findings on an instrumental assessment (P\u00a0=\u00a00.013) to be significantly associated with the need for revision supraglottoplasty. Binary regression analysis showed aspiration (OR\u00a0=\u00a05.6 {2.087-14.889}, P=<0.001) and cyanosis (OR\u00a0=\u00a05.3 {1.852-15.181}, P\u00a0=\u00a00.002) to be the only independent predictors of revision supraglottoplasty.",
    "title": "Dysphagia is a strong predictor of revision supraglottoplasty in pediatric laryngomalacia.",
    "xml": "<Element 'PubmedArticle' at 0x788506a68c70>"
}